Individual
DR. ALDO T IACONO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
410 LAKEVILLE ROAD, SUITE 105, NEW HYDE PARK, NY 11042
(516) 465-5417
(516) 465-5392
Mailing address
410 LAKEVILLE ROAD, SUITE 105, NEW HYDE PARK, NY 11042
(516) 465-5417
(516) 465-5392
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
D62655
MD
207RP1001X
Pulmonary Disease Physician
D62655
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
054292100
—
DC
05
—
1962456392
—
DE
05
—
406952800
—
MD
01
—
645699-01
BLUE CROSS/BLUE SHIELD
MD
01
—
S062-0256
CAREFIRST BC/BS
MD
Enumeration date
05/20/2006
Last updated
09/02/2022
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