Organization
ANNETTE RACANIELLO D O P C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NANCY RACANIELLO (OFFICE MANAGER)
(631) 286-2355
Entity
Organization
Contact information
Practice address
1 ANDIRON LN, BROOKHAVEN, NY 11719-9534
(631) 286-2355
(631) 286-6808
Mailing address
PO BOX 78, BROOKHAVEN, NY 11719-0078
(631) 286-2355
(631) 286-6808
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
157578
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01153048
—
NY
05
—
03197073
—
NY
Enumeration date
04/28/2009
Last updated
07/07/2010
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