# ANNETTE RACANIELLO D O P C

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1700020260
- **Authorized official:** MRS. NANCY RACANIELLO (OFFICE MANAGER)
- **Authorized official phone:** (631) 286-2355

## Contact information

- **Practice address:** 1 ANDIRON LN, BROOKHAVEN, NY 11719-9534
- **Practice address phone:** (631) 286-2355
- **Practice address fax:** (631) 286-6808
- **Mailing address:** PO BOX 78, BROOKHAVEN, NY 11719-0078
- **Mailing address phone:** (631) 286-2355
- **Mailing address fax:** (631) 286-6808

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 157578 | NY | Yes |

## Other

- **Enumeration date:** 04/28/2009
- **Last updated:** 07/07/2010