Gustavo Raul Depetris, MD Valid NPI

Individual provider · Internal Medicine Physician · Astoria, NY

NPI

1942226410

Type

Individual (Type 1)

Primary specialty

Internal Medicine Physician (Internal Medicine)

Specialty group

Allopathic & Osteopathic Physicians

Taxonomy code

207R00000X

License number

196792 (NY)

Sex

Male

Sole proprietor

Yes

Enumerated

2006-07-15

Last updated

2007-07-08