MEDICARE: DR ANGELO PORCARI MEDICAL SERVICES PC

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	207Q00000X	Family Medicine Physician	181477	NY

General Provider Information

NPI Number	:	1538345780
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR ANGELO PORCARI MEDICAL SERVICES PC

Provider Business Mailing Address
First Line	:	361 S 4TH ST
Second Line	:
City	:	FULTON
State	:	NY
Zip	:	13069-2532
Country	:	US
Telephone Number	:	315-598-5373
Fax Number	:	315-598-2304

Provider Business Practice Location Address
First Line	:	361 S 4TH ST
Second Line	:
City	:	FULTON
State	:	NY
Zip	:	13069-2532
Country	:	US
Telephone Number	:	315-598-5373
Fax Number	:	315-598-2304

Authorized Official
Title or Position	:	PHYSICIAN/OWNER
Name	:	DR. ANGELO PORCARI
Credential	:	MD
Telephone Number	:	315-598-5373

Provider Enumeration Date	:	01/18/2008
Last Update Date	:	01/18/2008

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