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General NPI Number Information
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NPI Number | 1972727295
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Entity Type | Individual
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Provider Name | VINCENT A PUCCIA M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/11/2007
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Last Update Date | 12/13/2010
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Provider Practice Location Address
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Address Line | 3229 162ND ST
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City | FLUSHING
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State | NY
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Zip | 11358-1324
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Country | US
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Telephone | 718-353-8441
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Fax | 718-359-8919
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Provider Business Mailing Address
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Address Line | 3229 162ND ST
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City | FLUSHING
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State | NY
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Zip | 11358-1324
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Country | US
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Telephone | 718-353-8441
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Fax | 718-359-8919
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RS0012X
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Taxonomy Name | Sleep Medicine (Internal Medicine) Physician
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License Number | 182488
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License Number State | NY
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