MEDICARE: DR. JAMES JOSEPH SCONZO DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	036399	NY

General Provider Information

NPI Number	:	1356335673
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES JOSEPH SCONZO DMD

Provider Business Mailing Address
First Line	:	1666 MARINE PKWY
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-4217
Country	:	US
Telephone Number	:	718-339-0252
Fax Number	:

Provider Business Practice Location Address
First Line	:	1666 MARINE PKWY
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-4217
Country	:	US
Telephone Number	:	718-339-0252
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2005
Last Update Date	:	03/18/2024

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