Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | N0048921 | NY |
NPI | 1184699795 |
---|---|
Provider Name | Dr. Gary Bartholomew Gugliada |
First Address | Staten Island, NY 10304-3944 |
Second Address | Staten Island, NY 10304-3944 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/02/2006 |
Last Update Date | 15/02/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01425227 | (05) | NY |
U34983 | (02) | NY |