Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RX0202X | Medical Oncology | 149994 | NY |
NPI | 1053308536 |
---|---|
Provider Name | Janet Gargiulo |
First Address | Cohoes, NY 12047-5003 |
Second Address | Cohoes, NY 12047-5003 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/09/2005 |
Last Update Date | 03/12/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B81665 | (02) |