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General NPI Number Information
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NPI Number | 1982917845
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Entity Type | Individual
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Provider Name | ALBERTO E PANIZ-MONDOLFI M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/21/2010
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Last Update Date | 09/01/2020
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Provider Practice Location Address
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Address Line | 1425 MADISON AVE RM L9-52B
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City | NEW YORK
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State | NY
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Zip | 10029-6514
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Country | US
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Telephone | 917-355-7530
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Fax |
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Provider Business Mailing Address
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Address Line | 10344 68TH AVE APT A
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City | FOREST HILLS
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State | NY
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Zip | 11375-3214
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Country | US
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Telephone | 917-803-1141
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Fax |
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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 | 207ZM0300X
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Taxonomy Name | Medical Microbiology Physician
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License Number | 301603
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License Number State | NY
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