Individual provider · NPI-1
Alan Mark Gandolfi, MD
Emergency Medicine · Southampton, NY
NPI number1497769541
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1497769541
- Entity type
- Individual (NPI-1)
- Name
- Alan Mark Gandolfi
- Credential
- MD
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jul 27, 2006
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207P00000X | Emergency Medicine | 149282 | NY | Yes |
Practice location
240 Meeting House LnSouthampton, NY 11968-5009
Phone 631-726-8420
Mailing address
Po Box 955Port Jefferson Station, NY 11776-0808
Phone 631-979-4400 · Fax 631-979-4475
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