=====================================================
General NPI Number Information
=====================================================
NPI Number | 1689654113
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ALESSANDRA PUGGIONI MD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/19/2006
-----------------------------------------------------
Last Update Date | 04/29/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 245 5TH AVE FL 3 C O LINA NOMAD
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10016-8278
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-457-1491
-----------------------------------------------------
Fax | 469-210-8571
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 886 2ND AVENUE PMB 113
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10017-2103
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-457-1491
-----------------------------------------------------
Fax | 692-108-5714
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number | 307007
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------