Provider Demographics
NPI:1154492148
Name:BOLOGNESE, PAOLO A (MD)
Entity Type:Individual
Prefix:DR
First Name:PAOLO
Middle Name:A
Last Name:BOLOGNESE
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1991 MARCUS AVE
Mailing Address - Street 2:SUITE 108
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11042-2057
Mailing Address - Country:US
Mailing Address - Phone:516-442-2250
Mailing Address - Fax:516-442-2251
Practice Address - Street 1:1991 MARCUS AVE
Practice Address - Street 2:SUITE 108
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11042-2057
Practice Address - Country:US
Practice Address - Phone:516-442-2250
Practice Address - Fax:516-442-2251
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2014-08-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY1519207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery