Provider Demographics
NPI:1457356065
Name:PAPALEO, MARCO S (MD)
Entity Type:Individual
Prefix:
First Name:MARCO
Middle Name:S
Last Name:PAPALEO
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 1:172 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-2948
Mailing Address - Country:US
Mailing Address - Phone:631-385-0022
Mailing Address - Fax:631-385-0896
Practice Address - Street 1:172 E MAIN ST
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-2948
Practice Address - Country:US
Practice Address - Phone:631-385-0022
Practice Address - Fax:631-385-0896
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY204195207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02321828Medicaid
NY446P61Medicare PIN
NY02321828Medicaid