Individual
MR. THEODORE MACARIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7901 BROADWAY, ELMHURST, NY 11373-1329
(718) 334-3050
(718) 334-3015
Mailing address
370 W 2ND ST, WEST ISLIP, NY 11795-2429
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
10/13/2015
Last updated
10/13/2015
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