Individual
MARK BOCCIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
27005 76TH AVE, NEW HYDE PARK, NY 11040-1402
(718) 470-5370
Mailing address
15612 28TH AVE, FLUSHING, NY 11354-1506
(917) 882-6124
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
026132
NY
Other
Enumeration date
02/27/2020
Last updated
03/24/2022
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