Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 0101241712 | VA |
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 249800 | NY |
NPI | 1083889539 |
---|---|
Provider Name | Dr. Calogero Gambino |
First Address | Brooklyn, NY 11209-7702 |
Second Address | Brooklyn, NY 11220-5350 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2008 |
Last Update Date | 04/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03023521 | (05) | NY |