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Organization

F PACIFICO PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. FERNANDO PACIFICO M.D. (PRESIDENT)
(718) 702-7216
Entity
Organization

Contact information

Practice address
60 QUEENS ST, SYOSSET, NY 11791-3058
(718) 702-7216
(831) 603-0351
Mailing address
60 QUEENS ST, SYOSSET, NY 11791-3058
(718) 702-7216
(831) 603-0351

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
141745
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00572472
NY
Enumeration date
12/06/2007
Last updated
04/27/2022
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