Individual
BRENTON FARGNOLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1275 YORK AVE, NEW YORK, NY 10065-6007
(212) 639-2000
Mailing address
1275 YORK AVE, NEW YORK, NY 10065-6110
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
251563
MA
207R00000X
Internal Medicine Physician
Primary
278451
NY
Other
Enumeration date
06/07/2012
Last updated
01/11/2016
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