Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 053752-1 | NY |
Y | 213EG0000X | General Practice | 053752-1 | NY |
NPI | 1003070574 |
---|---|
Provider Name | Dr. Richard Francis Porcelli |
First Address | Lynbrook, NY 11563-2641 |
Second Address | Lynbrook, NY 11563-2641 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2008 |
Last Update Date | 14/07/2008 |