Provider Demographics
NPI:1184733222
Name:PARISI, LUIGI J (MD)
Entity type:Individual
Prefix:
First Name:LUIGI
Middle Name:J
Last Name:PARISI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1491 RICHMOND RD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10304-2311
Mailing Address - Country:US
Mailing Address - Phone:718-979-1777
Mailing Address - Fax:718-273-4394
Practice Address - Street 1:1491 RICHMOND RD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10304-2311
Practice Address - Country:US
Practice Address - Phone:718-979-1777
Practice Address - Fax:718-273-4394
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2015-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY176031207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY908873OtherPHS
NY0P045OtherOXFORD
NY01142709Medicaid
NY0079008OtherGHI
NY02935OtherHIP
NY160354OtherELDERPLAN
NY19F011OtherBLUE CROSS
NY01142709Medicaid