Provider Demographics
NPI:1255627816
Name:FIORELLA NEUROLOGY, PC
Entity type:Organization
Organization Name:FIORELLA NEUROLOGY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARCO
Authorized Official - Middle Name:
Authorized Official - Last Name:PAPPAGALLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-692-6243
Mailing Address - Street 1:5 E 128TH ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10035-1282
Mailing Address - Country:US
Mailing Address - Phone:212-996-6716
Mailing Address - Fax:
Practice Address - Street 1:5 E 128TH ST
Practice Address - Street 2:SUITE 1
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10035-1282
Practice Address - Country:US
Practice Address - Phone:212-996-6716
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-22
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY180493208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty