MEDICARE: DR. LUIGIA GINA NOTARISTEFANO M.D.

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	203453	NY

General Provider Information

NPI Number	:	1093897118
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LUIGIA GINA NOTARISTEFANO M.D.

Provider Business Mailing Address
First Line	:	1591 ROUTE 22
Second Line	:
City	:	BREWSTER
State	:	NY
Zip	:	10509-4026
Country	:	US
Telephone Number	:	845-278-8797
Fax Number	:

Provider Business Practice Location Address
First Line	:	1591 ROUTE 22
Second Line	:
City	:	BREWSTER
State	:	NY
Zip	:	10509-4026
Country	:	US
Telephone Number	:	845-278-8797
Fax Number	:

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

Provider Enumeration Date	:	10/19/2006
Last Update Date	:	07/09/2008

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