Healthcare Provider Details

I. General information

NPI: 1477528107
Provider Name (Legal Business Name): JAMES J TUCCI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/17/2006
Last Update Date: 04/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

170 WILLIAM ST 8TH FLOOR
NEW YORK NY
10038-2612
US

IV. Provider business mailing address

170 WILLIAM ST 8TH FLOOR
NEW YORK NY
10038-2612
US

V. Phone/Fax

Practice location:
  • Phone: 212-312-5949
  • Fax: 212-312-5481
Mailing address:
  • Phone: 212-312-5949
  • Fax: 212-312-5481

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080S0010X
TaxonomyPediatric Sports Medicine Physician
License Number158863
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: