Provider Demographics
NPI:1720147085
Name:DEGREGORIO, PAOLA S (PA)
Entity Type:Individual
Prefix:MS
First Name:PAOLA
Middle Name:S
Last Name:DEGREGORIO
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Gender:F
Credentials:PA
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Mailing Address - Street 1:1 GUSTAVE L LEVY PL
Mailing Address - Street 2:BOX 3000
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-6500
Mailing Address - Country:US
Mailing Address - Phone:212-987-3100
Mailing Address - Fax:212-731-5210
Practice Address - Street 1:1 GUSTAVE L LEVY PL
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6500
Practice Address - Country:US
Practice Address - Phone:212-241-6756
Practice Address - Fax:212-423-0522
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2013-04-24
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Provider Licenses
StateLicense IDTaxonomies
NY003970363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant