Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 243765 | NY |
N | 2084N0600X | Clinical Neurophysiologist | 243765 | NY |
NPI | 1427227818 |
---|---|
Provider Name | Dr. Deana Marie Gazzola |
First Address | New York, NY 10016-4852 |
Second Address | New York, NY 10016-4852 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/02/2008 |
Last Update Date | 11/03/2021 |