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General NPI Number Information
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NPI Number | 1548286081
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Entity Type | Organization
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Legal Business Name | MORETTI & RACCO MEDICAL ASSOCIATES PC
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Dates
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Enumeration Date | 07/15/2006
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Last Update Date | 01/08/2009
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Provider Practice Location Address
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Address Line | 1870 RICHMOND RD
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City | STATEN ISLAND
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State | NY
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Zip | 10306-2553
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Country | US
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Telephone | 718-351-2192
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Fax | 718-980-6012
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Provider Business Mailing Address
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Address Line | 1870 RICHMOND RD
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City | STATEN ISLAND
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State | NY
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Zip | 10306-2553
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Country | US
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Telephone | 718-351-2192
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Fax | 718-980-6012
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Authorized Official
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Title or Position | OWNER
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Name | DR. ALEX RACCO
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Credential | DO
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Telephone | 718-351-2192
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207U00000X
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Taxonomy Name | Nuclear Medicine Physician
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License Number |
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State | NY
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