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General NPI Number Information
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NPI Number | 1871711127
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Entity Type | Individual
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Provider Name | ROGER A PIERANGELO PH.D
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Gender | Male
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 316 PARK AVE
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City | MANHASSET
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State | NY
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Zip | 11030-2417
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Country | US
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Telephone | 516-365-7862
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Fax | 516-627-1229
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Provider Business Mailing Address
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Address Line | 316 PARK AVE
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City | MANHASSET
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State | NY
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Zip | 11030-2417
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Country | US
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Telephone | 516-365-7862
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Fax | 516-627-1229
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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 | 103TC0700X
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Taxonomy Name | Clinical
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License Number | 007385-1
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License Number State | NY
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