Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086X0206X | Surgical Oncologist | 273452 | NY |
NPI | 1205062221 |
---|---|
Provider Name | Dr. Jennifer Rose Cracchiolo |
First Address | New York, NY 10065-7924 |
Second Address | New York, NY 10065-6007 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2009 |
Last Update Date | 02/06/2017 |