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NPI Code Detail

MEDICARE: MR. CARL A. GARGIULO PT, DPT, OCS

MEDICARE: MR. CARL A. GARGIULO PT, DPT, OCS
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
1174400000XSpecialist40QA00175100NJ
2225100000XPhysical Therapist40QA00175100NJ

General Provider Information

NPI Number : 1013961523
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. CARL A. GARGIULO PT, DPT, OCS
Provider Business Mailing Address
First Line : 1 NARDONE PL
Second Line :
City : JERSEY CITY
State : NJ
Zip : 07306-3514
Country : US
Telephone Number : 201-792-3840
Fax Number : 201-792-7948
Provider Business Practice Location Address
First Line : 1 NARDONE PL
Second Line :
City : JERSEY CITY
State : NJ
Zip : 07306-3514
Country : US
Telephone Number : 201-792-3840
Fax Number : 201-792-7948
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2006
Last Update Date : 12/30/2019

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