Individual
MR. JAMES DECICCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OPTICIAN
Contact information
Practice address
699A OLD COUNTRY RD, HUNTINGTON STATION, NY 11746-4613
(631) 271-3520
(631) 271-3706
Mailing address
699A OLD COUNTRY RD, HUNTINGTON STATION, NY 11746-4613
(631) 271-3520
(631) 271-3706
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
5410
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00991259
—
NY
Enumeration date
01/12/2007
Last updated
09/02/2010
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