MEDICARE: DR. JOSEPH RALPH ANTICAGLIA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Y00000X	Otolaryngology Physician	224289	NY

General Provider Information

NPI Number	:	1487624706
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH RALPH ANTICAGLIA M.D.

Provider Business Mailing Address
First Line	:	875 OLD COUNTRY RD
Second Line	:	SUITE 200
City	:	PLAINVIEW
State	:	NY
Zip	:	11803-4942
Country	:	US
Telephone Number	:	516-931-5552
Fax Number	:	516-931-6563

Provider Business Practice Location Address
First Line	:	875 OLD COUNTRY RD
Second Line	:	SUITE 200
City	:	PLAINVIEW
State	:	NY
Zip	:	11803-4942
Country	:	US
Telephone Number	:	516-931-5552
Fax Number	:	516-931-6563

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/26/2006
Last Update Date	:	01/06/2010

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