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General NPI Number Information
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NPI Number | 1720069610
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Entity Type | Individual
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Provider Name | MARCO PAPPAGALLO MD
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Gender | Male
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Dates
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Enumeration Date | 11/08/2005
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Last Update Date | 12/23/2019
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Provider Practice Location Address
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Address Line | 5 E 128TH ST
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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 | 917-692-6243
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Fax | 646-799-9727
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Provider Business Mailing Address
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Address Line | 5 E 128TH ST
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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 | 917-692-6243
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Fax | 646-799-9727
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 25MA09578600
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | 25MA09578600
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 180493
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 25MA09578600
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License Number State | NJ
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Taxonomy #5
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 180493
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License Number State | NY
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Taxonomy #6
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | 180493
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License Number State | NY
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