Individual
DR. JOHN A FACCONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
900 STUYVESANT AVE, UNION, NJ 07083-6936
(908) 964-6600
(908) 936-4101
Mailing address
900 STUYVESANT AVE, UNION, NJ 07083-6936
(908) 964-6600
(908) 364-1016
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MB63614
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0599209
GHI
NJ
01
—
0824982000
AMERIHEALTH
NJ
01
—
7410124
AETNA
NJ
05
—
8456607
—
NJ
01
—
P2107734
OXFORD
NJ
Enumeration date
07/15/2005
Last updated
04/01/2010
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