Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 178508 | NY |
NPI | 1063483709 |
---|---|
Provider Name | Dr. Robert M Gargano |
First Address | Tarrytown, NY 10591-5139 |
Second Address | Islandia, NY 11749-5306 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/01/2006 |
Last Update Date | 02/04/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E17256 | (02) | NY |