Provider Demographics
NPI:1427029461
Name:HORMIGO, ADILIA M (MD, PHD)
Entity Type:Individual
Prefix:
First Name:ADILIA
Middle Name:M
Last Name:HORMIGO
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 GUSTAVE L LEVY PLACE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-6574
Mailing Address - Country:US
Mailing Address - Phone:212-824-8579
Mailing Address - Fax:646-537-9639
Practice Address - Street 1:1 GUSTAVE L LEVY PLACE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6574
Practice Address - Country:US
Practice Address - Phone:212-824-8579
Practice Address - Fax:646-537-9639
Is Sole Proprietor?:No
Enumeration Date:2006-01-28
Last Update Date:2015-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2262502084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
I01136Medicare UPIN
482N71Medicare ID - Type Unspecified
NYJ400055736Medicare PIN