Provider Demographics
NPI:1306808431
Name:GARGIULLO, LUZ P (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:LUZ
Middle Name:P
Last Name:GARGIULLO
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1099 OLYMPIA RD
Mailing Address - Street 2:
Mailing Address - City:NORTH BELLMORE
Mailing Address - State:NY
Mailing Address - Zip Code:11710-1938
Mailing Address - Country:US
Mailing Address - Phone:516-729-9261
Mailing Address - Fax:516-221-6881
Practice Address - Street 1:1099 OLYMPIA RD
Practice Address - Street 2:
Practice Address - City:NORTH BELLMORE
Practice Address - State:NY
Practice Address - Zip Code:11710-1938
Practice Address - Country:US
Practice Address - Phone:516-729-9261
Practice Address - Fax:516-221-6881
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF340044-2363LG0600X
NYF34-00442363LG0600X
NYF340044-1363LG0600X
NYF300398-01363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology