Individual
DR. ANNETTE F RACANIELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1 ANDIRON LN, BROOKHAVEN, NY 11719-0078
(631) 286-2355
(631) 286-6808
Mailing address
PO BOX 78, BROOKHAVEN, NY 11719-0078
(631) 286-2355
(631) 286-6808
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
157578
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01153048
—
NY
Enumeration date
10/03/2005
Last updated
05/01/2012
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