Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0401X | Family Doctor - Addiction Medicine | D25774 | MD |
NPI | 1447225719 |
---|---|
Provider Name | Dr. Natale Joseph Gagliardi |
First Address | Columbia, MD 21045-2218 |
Second Address | Pasadena, MD 21122-2300 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2006 |
Last Update Date | 22/03/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
15740-1900 | (05) | MD |
B-67245 | (02) | MD |