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NPI Code Detail

MEDICARE: JOSEPH PORTELLI

MEDICARE:   JOSEPH  PORTELLI
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training ProgramNY

General Provider Information

NPI Number : 1003759770
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSEPH PORTELLI
Provider Business Mailing Address
First Line : 1824 MADISON AVE
Second Line :
City : NEW YORK
State : NY
Zip : 10035-3832
Country : US
Telephone Number : 212-423-4500
Fax Number :
Provider Business Practice Location Address
First Line : 1824 MADISON AVE
Second Line :
City : NEW YORK
State : NY
Zip : 10035-3832
Country : US
Telephone Number : 212-423-4500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/09/2026
Last Update Date : 04/09/2026

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Directions to “ JOSEPH PORTELLI ” Practice Location

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