Provider Demographics
NPI:1881856003
Name:PARGOLA, EILEEN (MD)
Entity Type:Individual
Prefix:
First Name:EILEEN
Middle Name:
Last Name:PARGOLA
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 1:1900 N 20TH ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19121-2217
Mailing Address - Country:US
Mailing Address - Phone:215-685-2973
Mailing Address - Fax:
Practice Address - Street 1:1900 N 20TH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19121-2217
Practice Address - Country:US
Practice Address - Phone:215-685-2973
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-29
Last Update Date:2013-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT191211207R00000X
PAMD439132207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine