Healthcare Provider Details

I. General information

NPI: 1720353303
Provider Name (Legal Business Name): DR JOSEPH CARACCILO DC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2012
Last Update Date: 05/23/2025
Certification Date: 05/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

52 E 11TH ST # GF
NEW YORK NY
10003-6001
US

IV. Provider business mailing address

52 E 11TH ST # GF
NEW YORK NY
10003-6001
US

V. Phone/Fax

Practice location:
  • Phone: 917-696-1249
  • Fax:
Mailing address:
  • Phone: 347-509-5907
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License NumberX006374-1
License Number StateNY

VIII. Authorized Official

Name: DR. JOSEPH CARACCILO
Title or Position: OWNER
Credential: DC
Phone: 349-509-5907