MEDICARE: GREGORY F GARGIULO D.O.

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	207R00000X	Internal Medicine Physician	4421	AZ

General Provider Information

NPI Number	:	1043248834
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GREGORY F GARGIULO D.O.

Provider Business Mailing Address
First Line	:	7032 W GREENBRIAR DR
Second Line	:	9TH FLOOR
City	:	GLENDALE
State	:	AZ
Zip	:	85308-8414
Country	:	US
Telephone Number	:	623-486-1782
Fax Number	:	623-486-1782

Provider Business Practice Location Address
First Line	:	7032 W GREENBRIAR DR
Second Line	:	9TH FLOOR
City	:	GLENDALE
State	:	AZ
Zip	:	85308-8414
Country	:	US
Telephone Number	:	623-486-1782
Fax Number	:	623-486-1782

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

Provider Enumeration Date	:	06/29/2006
Last Update Date	:	10/19/2011

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