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Individual

DR. JOHN A PROCACCINO JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
900 NORTHERN BLVD, GREAT NECK, NY 11021-5302
(516) 730-2100
(516) 730-2121
Mailing address
972 BRUSH HOLLOW RD, WESTBURY, NY 11590-1740
(516) 876-5555
(516) 876-5539

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
171315
NY

Other

Enumeration date
01/24/2006
Last updated
09/23/2013
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