Individual
JEFFREY L VACIRCA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1500 ROUTE 112, BLDG 4, PORT JEFFERSON STATION, NY 11776-8055
(631) 574-8354
(631) 509-6559
Mailing address
1500 ROUTE 112, BLDG 4, PORT JEFFERSON STATION, NY 11776-8055
(631) 574-8354
(631) 509-6559
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
222234
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02521837
—
NY
Enumeration date
06/13/2005
Last updated
11/14/2019
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