Individual provider · NPI-1

Dr. Roberto C.M. Bergamaschi, MD

Surgery · Stony Brook, NY

NPI number1497755318
StatusActive
Last updated in NPPESMay 2, 2017

Details

NPI
1497755318
Entity type
Individual (NPI-1)
Name
Dr. Roberto C.M. Bergamaschi
Credential
MD
Sex
Male
Sole proprietor
No
Enumeration date
Jul 22, 2005
Last updated
May 2, 2017

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
208600000X Surgery250434-1NYYes
208600000X SurgeryMD420914PA

Practice location

Hsc T19-020
Stony Brook, NY 11794-8191

Phone 631-444-2704 · Fax 631-444-6348

Mailing address

Hsc T19 020
Stony Brook, NY 11794-8191

Phone 631-444-2704 · Fax 631-444-6348

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