Individual
JOHN J BUCCELLATO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1500 LEXINGTON AVE, NEW YORK, NY 10029-7349
(212) 710-1065
(212) 736-3229
Mailing address
1345 RXR PLZ FL 13, UNIONDALE, NY 11556-1301
(516) 453-0435
(646) 846-3283
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
181208
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01277018
—
NY
Enumeration date
07/25/2006
Last updated
12/06/2019
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