Provider Demographics
NPI:1295851020
Name:EDUARDO L. PIGNANELLI, PHYSICIAN P.C.
Entity type:Organization
Organization Name:EDUARDO L. PIGNANELLI, PHYSICIAN P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EDUARDO
Authorized Official - Middle Name:L
Authorized Official - Last Name:PIGNANELLI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-923-0559
Mailing Address - Street 1:2360 AMSTERDAM AVE
Mailing Address - Street 2:STE M1
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-7362
Mailing Address - Country:US
Mailing Address - Phone:212-923-0559
Mailing Address - Fax:212-740-4930
Practice Address - Street 1:2360 AMSTERDAM AVE
Practice Address - Street 2:STE M1
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-7362
Practice Address - Country:US
Practice Address - Phone:212-923-0559
Practice Address - Fax:212-740-4930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2011-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207RC0000X, 207RG0100X
NY190569207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01466820Medicaid
NYW38711Medicare ID - Type Unspecified
NY01466820Medicaid