Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0200X | Critical Care Medicine | 175954 | NY |
N | 207RP1001X | Pulmonary Disease | 175954 | NY |
NPI | 1043385024 |
---|---|
Provider Name | Joseph L Saraceno |
First Address | Bay Shore, NY 11706 |
Second Address | Bay Shore, NY 11706 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/11/2006 |
Last Update Date | 28/07/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01488068 | (05) | NY |
F90932 | (02) |