Provider Demographics
NPI:1639134539
Name:DRAGONETTI, MARIE ELENA (DO)
Entity Type:Individual
Prefix:
First Name:MARIE ELENA
Middle Name:
Last Name:DRAGONETTI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 FRANKLIN AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-2910
Mailing Address - Country:US
Mailing Address - Phone:516-248-6868
Mailing Address - Fax:516-248-6841
Practice Address - Street 1:1000 FRANKLIN AVE STE 300
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-2910
Practice Address - Country:US
Practice Address - Phone:516-248-6868
Practice Address - Fax:516-248-6841
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2021-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2171031207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine