Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 196145I | NY |
N | 208600000X | Surgeon | 196145I | NY |
N | 208200000X | Surgeon | 25MA05542200 | NJ |
N | 208600000X | Surgeon | 25MA05542200 | NJ |
N | 2086X0206X | Surgical Oncologist | 125MA05542200 | NJ |
Y | 2086X0206X | Surgical Oncologist | 196145I | NY |
NPI | 1013961309 |
---|---|
Provider Name | Dr. Joseph S Raccuia |
First Address | New York, NY 10011-8300 |
Second Address | Hoboken, NJ 07030-3794 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2006 |
Last Update Date | 14/12/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01608511 | (05) | NY |
F19443 | (02) | NY |