Provider Demographics
NPI:1255345146
Name:GARGIULO, ANTONIO ROSARIO (MD)
Entity type:Individual
Prefix:
First Name:ANTONIO
Middle Name:ROSARIO
Last Name:GARGIULO
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Gender:M
Credentials:MD
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Mailing Address - Street 1:75 FRANCIS STREET
Mailing Address - Street 2:BRIGHAM AND WOMEN'S HOSPITAL DEPARTMENT OF OBSTETRICIAN
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115
Mailing Address - Country:US
Mailing Address - Phone:617-732-4285
Mailing Address - Fax:617-975-8070
Practice Address - Street 1:75 FRANCIS STREET
Practice Address - Street 2:BRIGHAM AND WOMENS HOSPITAL CENTER FOR REPRODUCTIVE MED
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115
Practice Address - Country:US
Practice Address - Phone:617-732-4285
Practice Address - Fax:617-975-8070
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2012-06-20
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Provider Licenses
StateLicense IDTaxonomies
MA150480207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAG68110Medicare UPIN