MEDICARE: DR. ANTHONY ACETO DDS

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	1223G0001X	General Practice Dentistry	24348	NY

General Provider Information

NPI Number	:	1487611521
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANTHONY ACETO DDS

Provider Business Mailing Address
First Line	:	50 COLUMBUS AVE
Second Line	:	APT. 609
City	:	TUCKAHOE
State	:	NY
Zip	:	10707-2527
Country	:	US
Telephone Number	:	914-793-3158
Fax Number	:	212-529-2071

Provider Business Practice Location Address
First Line	:	50 COLUMBUS AVE
Second Line	:	APT. 609
City	:	TUCKAHOE
State	:	NY
Zip	:	10707-2527
Country	:	US
Telephone Number	:	914-793-3158
Fax Number	:	212-529-2071

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

Provider Enumeration Date	:	05/01/2006
Last Update Date	:	07/08/2007

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