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General NPI Number Information
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NPI Number | 1184637662
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Entity Type | Organization
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Legal Business Name | P.A. TERRACIANO, M.D., P.C.
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Dates
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Enumeration Date | 08/14/2006
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Last Update Date | 10/23/2007
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Provider Practice Location Address
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Address Line | 2241 ESPLANADE AVE
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City | BRONX
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State | NY
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Zip | 10469-5405
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Country | US
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Telephone | 718-654-7122
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Fax |
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Provider Business Mailing Address
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Address Line | 2241 ESPLANADE AVE
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City | BRONX
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State | NY
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Zip | 10469-5405
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Country | US
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Telephone | 718-654-7122
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. ANTHONY TERRACIANO
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Credential | MD
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Telephone | 718-654-7122
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 91750
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 214528
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License Number State | NY
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