Individual
PATRICIO PAUL GALLARDO AVILA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3332 BROADWAY, NEW YORK, NY 10031-8732
(212) 694-2000
(212) 694-2936
Mailing address
3332 BROADWAY, NEW YORK, NY 10031-8732
(212) 694-2000
(212) 694-2936
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
305493
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09677386
ECFMG/USMLE NUMBER
—
Enumeration date
07/06/2017
Last updated
01/25/2021
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