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Individual

GENE R PESOLA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2525 KINGS HWY, BROOKLYN, NY 11229-1705
(718) 692-5300
(516) 437-4167
Mailing address
1981 MARCUS AVE, SUITE 208, LAKE SUCCESS, NY 11042-1038
(718) 670-1651
(516) 437-4167

Taxonomy

Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
151334
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01123151
NY
Enumeration date
06/30/2006
Last updated
11/02/2010
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