Individual
DR. JUAN J GARGIULO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
365 COUNTY ROAD 39A, SUITE 15 & 16, SOUTHAMPTON, NY 11968-5284
(631) 702-2300
(631) 702-2303
Mailing address
PO BOX 5072, SOUTHAMPTON, NY 11969-5072
(631) 702-2300
(631) 702-2303
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
181791
NY
207LP2900X
Pain Medicine (Anesthesiology) Physician
181791
NY
208VP0014X
Interventional Pain Medicine Physician
Primary
181791
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01355302
—
NY
Enumeration date
05/23/2006
Last updated
06/14/2012
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