Individual
DR. GARY LOUIS MUCCIOLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
40 E 88TH ST, NEW YORK, NY 10128-1176
(212) 722-9196
(212) 722-0911
Mailing address
40 EAST 88THSTREET, NEW YORK, NY 10128
(212) 722-9196
(212) 722-0911
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
131722
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
36A72
EMPIRE BC
NY
01
—
OM1328
HEALTHNET
NY
01
—
P2094193
OXFORD
NY
Enumeration date
03/07/2007
Last updated
07/08/2007
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