Individual
GAETANO PERILLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3004 ROBERTS AVE, BRONX, NY 10461
(718) 931-8041
(718) 931-5815
Mailing address
3004 ROBERTS AVE, BRONX, NY 10461
(718) 931-8041
(718) 931-5815
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
202014
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01889761
—
NY
Enumeration date
09/01/2006
Last updated
03/18/2015
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