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General NPI Number Information
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NPI Number | 1255627816
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Entity Type | Organization
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Legal Business Name | FIORELLA NEUROLOGY, PC
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Dates
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Enumeration Date | 06/22/2011
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Last Update Date | 06/22/2011
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Provider Practice Location Address
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Address Line | 5 E 128TH ST SUITE 1
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City | NEW YORK
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State | NY
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Zip | 10035-1282
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Country | US
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Telephone | 212-996-6716
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Fax |
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Provider Business Mailing Address
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Address Line | 5 E 128TH ST SUITE 1
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City | NEW YORK
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State | NY
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Zip | 10035-1282
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Country | US
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Telephone | 212-996-6716
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARCO PAPPAGALLO
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Credential | M.D.
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Telephone | 917-692-6243
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number | 180493
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License Number State | NY
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