Organization
ICA SURGERY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH S RACCUIA (PRESIDENT)
(212) 647-0404
Entity
Organization
Contact information
Practice address
36 7TH AVE, SUITE 402, NEW YORK, NY 10011-6609
(212) 647-0404
(212) 647-0499
Mailing address
70A GREENWICH AVENUE, SUITE 101, NEW YORK, NY 10011
(212) 647-0404
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Enumeration date
06/07/2007
Last updated
08/22/2020
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