MEDICARE: P LEO VARRIALE MD

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
1	174400000X	Specialist	142866	NY

General Provider Information

NPI Number	:	1013907146
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	P LEO VARRIALE MD

Provider Business Mailing Address
First Line	:	601 FRANKLIN AVE
Second Line	:	SUITE 215
City	:	GARDEN CITY
State	:	NY
Zip	:	11530-5795
Country	:	US
Telephone Number	:	516-248-1314
Fax Number	:	516-873-6623

Provider Business Practice Location Address
First Line	:	601 FRANKLIN AVE
Second Line	:	SUITE 215
City	:	GARDEN CITY
State	:	NY
Zip	:	11530-5795
Country	:	US
Telephone Number	:	516-248-1314
Fax Number	:	516-873-6623

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/28/2005
Last Update Date	:	11/23/2009

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