Organization
JOHN J DECICCO D P M PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN J DECICCO (OWNER)
(516) 681-8866
Entity
Organization
Contact information
Practice address
875 OLD COUNTRY RD, SUITE 100, PLAINVIEW, NY 11803-4942
(516) 681-8866
(516) 681-8890
Mailing address
875 OLD COUNTRY RD, SUITE 100, PLAINVIEW, NY 11803-4942
(516) 681-8866
(516) 681-8890
Taxonomy
Speciality
Code
Description
License number
State
261QP1100X
Podiatric Clinic/Center
Primary
—
—
Other
Enumeration date
03/25/2008
Last updated
01/31/2013
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