Organization
SJR MEDICAL, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL P. ANTONECCHIA MD (M.D)
(914) 964-4965
Entity
Organization
Contact information
Practice address
1088 NORTH BROADWAY, YONKERS, NY 10701
(914) 207-0004
(914) 965-0107
Mailing address
PO BOX 998, ATTN: RIVERSIDE MANAGEMENT SERVICES ORG, YONKERS, NY 10703-0998
(914) 966-9787
(914) 966-9793
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207RG0100X
Gastroenterology Physician
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
—
207RN0300X
Nephrology Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
—
—
2084P0800X
Psychiatry Physician
—
—
208M00000X
Hospitalist Physician
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02384247
—
NY
Enumeration date
07/15/2006
Last updated
05/16/2025
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