Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Charlie Louie Gagliardo, PA

Individual provider Physician Assistant · NPI 1487086419

Mr. Charlie Louie Gagliardo, PA is a Physician Assistant in Astoria, New York. Qualified in 2013, 13 years ago. Practices with Icahn School of Medicine at Mount Sinai, a 2,791-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
13
Licensed in
NY
In the registry since
2013
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

2510 30th Ave
Astoria, NY 11102-2418
Phone: (718) 932-1000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 016762 (NY)

Record details

NPI number1487086419
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedAugust 1, 2013
Last updated in NPPESJuly 17, 2023
Certification dateJuly 17, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2013 (13 years in practice)
Group practice Icahn School Of Medicine At Mount Sinai — 2791 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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