Provider Demographics
NPI:1437110814
Name:PRIOLO, LOUISE MARIE (190397-1)
Entity Type:Individual
Prefix:DR
First Name:LOUISE
Middle Name:MARIE
Last Name:PRIOLO
Suffix:
Gender:F
Credentials:190397-1
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1984 RICHMOND RD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10306-2550
Mailing Address - Country:US
Mailing Address - Phone:718-667-1111
Mailing Address - Fax:718-667-1388
Practice Address - Street 1:1984 RICHMOND RD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10306-2550
Practice Address - Country:US
Practice Address - Phone:718-667-1111
Practice Address - Fax:718-667-1388
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY190397-1207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF56423Medicare UPIN
NY67H9310Medicare ID - Type Unspecified