Healthcare Provider Details
I. General information
NPI: 1811190184
Provider Name (Legal Business Name): HEPATOBILIARY & TUMOR SURGERY, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/06/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
36 7TH AVE SUITE 402
NEW YORK NY
10011-6609
US
IV. Provider business mailing address
70A GREENWICH AVE SUITE 101
NEW YORK NY
10011-8300
US
V. Phone/Fax
- Phone: 212-647-0404
- Fax: 212-647-0499
- Phone: 212-647-0404
- Fax: 212-647-0499
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
JOSEPH
S
RACCUIA
Title or Position: PRESIDENT
Credential:
Phone: 212-647-0404