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General NPI Number Information
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NPI Number | 1265852545
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Entity Type | Organization
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Legal Business Name | STEPHEN P BRACCI MD PLLC
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Dates
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Enumeration Date | 04/24/2014
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Last Update Date | 08/08/2014
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Provider Practice Location Address
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Address Line | 240 E 60TH ST
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City | NEW YORK
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State | NY
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Zip | 10022-1402
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Country | US
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Telephone | 212-888-3003
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Fax |
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Provider Business Mailing Address
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Address Line | 240 E 60TH ST
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City | NEW YORK
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State | NY
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Zip | 10022-1402
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Country | US
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Telephone | 212-888-3003
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. STEPHEN PAUL BRACCI
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Credential | M.D.
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Telephone | 212-888-3003
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 25MA70197400
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | ME0075265
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 199425
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License Number State | NY
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