Individual
ANTHONY ANTONACCI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
130 E 77TH ST, 13 FL, NEW YORK, NY 10075-1851
(212) 434-3420
Mailing address
PO BOX 32936, HARTFORD, CT 06150-2936
(212) 256-3539
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
135626
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00844293
—
NY
Enumeration date
11/15/2005
Last updated
07/06/2010
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