Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 247484 | NY |
N | 207PE0004X | Emergency Medical Services | 247484 | NY |
NPI | 1194993881 |
---|---|
Provider Name | Dr. Nicholas Justin Vaccari |
First Address | New York, NY 10087-5450 |
Second Address | Brooklyn, NY 11215-3609 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/02/2008 |
Last Update Date | 07/03/2013 |