Individual
DR. DENNIS L. PICCONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
9710 VENTNOR AVE, MARGATE, NJ 08402-2223
(609) 822-4800
(609) 822-2617
Mailing address
9710 VENTNOR AVE, MARGATE, NJ 08402-2223
(609) 822-4800
(609) 822-2617
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MB033327
NJ
208D00000X
General Practice Physician
25MB03332700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19826
AMERIGROUP
NJ
01
—
222725033
TAX ID#
NJ
Enumeration date
06/21/2006
Last updated
10/19/2020
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