Individual
MR. JOSEPH T MICCOLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPA-C
Contact information
Practice address
215 ROCKAWAY TPKE, LAWRENCE, NY 11559-1216
(516) 374-5024
(516) 374-5816
Mailing address
215 ROCKAWAY TPKE, LAWRENCE, NY 11559-1216
(516) 374-5024
(516) 374-5816
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
013446
NY
Other
Enumeration date
08/11/2009
Last updated
08/05/2016
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