Provider Demographics
NPI:1982917845
Name:PANIZ-MONDOLFI, ALBERTO E (MD)
Entity Type:Individual
Prefix:DR
First Name:ALBERTO
Middle Name:E
Last Name:PANIZ-MONDOLFI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ALBERTO
Other - Middle Name:E
Other - Last Name:PANIZ MONDOLFI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD, PHD
Mailing Address - Street 1:10344 68TH AVE APT A
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-3214
Mailing Address - Country:US
Mailing Address - Phone:917-803-1141
Mailing Address - Fax:
Practice Address - Street 1:1425 MADISON AVE RM L9-52B
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6514
Practice Address - Country:US
Practice Address - Phone:917-355-7530
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-21
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY301603207ZM0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZM0300XAllopathic & Osteopathic PhysiciansPathologyMedical Microbiology