Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | 303348 | NY |
NPI | 1306264528 |
---|---|
Provider Name | Michael Ingargiola |
First Address | Pearl River, NY 10965-2253 |
Second Address | Pearl River, NY 10965-2253 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2014 |
Last Update Date | 22/06/2020 |