Provider Demographics
NPI:1659585131
Name:LAGO TORO, CLAUDIA ELISA (MD)
Entity Type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:ELISA
Last Name:LAGO TORO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 READE PL STE 2300
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-3968
Mailing Address - Country:US
Mailing Address - Phone:845-790-8855
Mailing Address - Fax:
Practice Address - Street 1:21 READE PL STE 2300
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-3968
Practice Address - Country:US
Practice Address - Phone:845-790-8855
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3267112086X0206X
ZZME1143652086X0206X
FLME114365208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0076606-00Medicaid
FL0076606-00Medicaid