Individual
DR. ANDREW ANGELO JACONO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
440-450 NORTHERN BLVD, GREAT NECK, NY 11021
(516) 773-4646
(516) 773-1360
Mailing address
440 NORTHERN BLVD, GREAT NECK, NY 11021
(516) 773-4646
(516) 773-1360
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
2089311
NY
208200000X
Plastic Surgery Physician
2089311
NY
Other
Enumeration date
08/02/2006
Last updated
02/17/2009
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