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Individual

JOHN DACONTI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
77 NEWARK AVE, SUITE 3 & 4, BELLEVILLE, NJ 07109-4143
(973) 528-2160
(973) 528-2165
Mailing address
66 SOMME ST, NEWARK, NJ 07105-3612
(973) 522-0006
(973) 522-0666

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MB03091800
NJ
207RA0401X
Addiction Medicine (Internal Medicine) Physician
XD3165075
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1287001
NJ
Enumeration date
05/04/2006
Last updated
08/15/2013
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