MEDICARE: DR. ALBERT B ACCETTOLA JR. MD

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	207X00000X	Orthopaedic Surgery Physician	1263871	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1972584696
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALBERT B ACCETTOLA JR. MD

Provider Business Mailing Address
First Line	:	2535 ARTHUR KILL RD
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10309-1207
Country	:	US
Telephone Number	:	718-448-3210
Fax Number	:	718-967-6023

Provider Business Practice Location Address
First Line	:	3311 HYLAN BLVD
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10306-3688
Country	:	US
Telephone Number	:	718-667-7500
Fax Number	:	718-351-1580

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

Provider Enumeration Date	:	11/09/2005
Last Update Date	:	06/24/2011

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