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Individual
DR. JOHN A FACCONE
Active
Individual
DR. JOHN A FACCONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MB63614
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0599209
GHI
NJ
01
—
0824982000
AMERIHEALTH
NJ
01
—
7410124
AETNA
NJ
05
—
8456607
—
NJ
01
—
P2107734
OXFORD
NJ
Enumeration date
07/15/2005
Last updated
04/01/2010
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