Individual
DR. JOHN ELMUCCIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
161 WILLIAM ST, 5TH FLOOR, NEW YORK, NY 10038-2607
(212) 788-5680
Mailing address
91 ILYSSA WAY, STATEN ISLAND, NY 10312-1360
(862) 268-2349
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
035457-1
NY
Other
Enumeration date
04/04/2007
Last updated
07/08/2007
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