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NPI Code Detail

MEDICARE: FERNANDO PACIFICO M.D.

MEDICARE: FERNANDO PACIFICO M.D.
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
1207R00000XInternal Medicine Physician141745NY

General Provider Information

NPI Number : 1396858205
Entity Type Code : Individual
Provider Name (Legal Business Name) : FERNANDO PACIFICO M.D.
Provider Business Mailing Address
First Line : 60 QUEENS ST
Second Line :
City : SYOSSET
State : NY
Zip : 11791-3058
Country : US
Telephone Number : 718-702-7216
Fax Number : 831-603-0351
Provider Business Practice Location Address
First Line : 60 QUEENS ST
Second Line :
City : SYOSSET
State : NY
Zip : 11791-3058
Country : US
Telephone Number : 718-702-7216
Fax Number : 718-831-6030
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2006
Last Update Date : 04/27/2022

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Directions to “ FERNANDO PACIFICO M.D.” Practice Location

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