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Individual
DR. JACK ITALIANO III
Active
Individual
DR. JACK ITALIANO III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
327932
NY
207X00000X
Orthopaedic Surgery Physician
327932
NY
Other
Enumeration date
03/30/2020
Last updated
04/02/2025
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