Healthcare Provider Details

I. General information

NPI: 1427322536
Provider Name (Legal Business Name): OFFICES FOR HEPATOBILIARY AND TUMOR SURGERY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2012
Last Update Date: 10/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

530 1ST AVE SUITE 5C
NEW YORK NY
10016-6402
US

IV. Provider business mailing address

70A GREENWICH AVE. SUITE 101
NEW YORK NY
10011
US

V. Phone/Fax

Practice location:
  • Phone: 212-263-8870
  • Fax: 646-501-5205
Mailing address:
  • Phone: 212-263-8870
  • Fax: 646-501-5205

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number196145-1
License Number StateNY

VIII. Authorized Official

Name: DR. JOSEPH S. RACCUIA
Title or Position: OWNER
Credential: MD
Phone: 212-263-8870