Organization
BERGAMO PODIATRY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY JOHN BERGAMO D.P.M. (PODIATRIST)
(845) 343-6050
Entity
Organization
Contact information
Practice address
110 E MAIN ST, MIDDLETOWN, NY 10940-5119
(845) 343-6050
Mailing address
110 E MAIN ST, MIDDLETOWN, NY 10940-5119
(845) 343-6050
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
NOO5115
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01515273
—
NY
01
—
1164420881
INDIVIDUAL NPI
NY
Enumeration date
05/20/2011
Last updated
05/20/2011
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