Healthcare Provider Details

I. General information

NPI: 1801840509
Provider Name (Legal Business Name): JOHN ZARCONE III MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 08/18/2023
Certification Date: 08/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3556 RICHMOND AVE
STATEN ISLAND NY
10312-3253
US

IV. Provider business mailing address

3556 RICHMOND AVE
STATEN ISLAND NY
10312-3253
US

V. Phone/Fax

Practice location:
  • Phone: 718-227-8346
  • Fax: 718-227-8344
Mailing address:
  • Phone: 718-227-8346
  • Fax: 718-227-8344

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number180726
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number201767
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number34661
License Number StateIA
# 4
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number36641
License Number StateIA
# 5
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number180726
License Number StateWI
# 6
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number201767
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: