| Anthony J Antonucci M D P C | |
|
830 Park Ave Carillon Nursing And Rehabilitation Center Huntington NY 11743-4543 | |
| (631) 827-6689 | |
| (631) 673-4936 |
| Full Name | Anthony J Antonucci M D P C |
|---|---|
| Speciality | Internal Medicine |
| Location | 830 Park Ave, Huntington, New York |
| Authorized Official Name and Position | Anthony J Antonucci (MD) |
| Authorized Official Contact | 6318276689 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Anthony J Antonucci M D P C 6 Hennessey Dr Huntington NY 11743-3824 Ph: (631) 827-6689 | Anthony J Antonucci M D P C 830 Park Ave Carillon Nursing And Rehabilitation Center Huntington NY 11743-4543 Ph: (631) 827-6689 |
| NPI Number | 1083751879 |
|---|---|
| Provider Enumeration Date | 01/31/2007 |
| Last Update Date | 01/23/2021 |
| Medicare PECOS PAC ID | 8426018383 |
|---|---|
| Medicare Enrollment ID | O20041014000775 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083751879 | NPI | - | NPPES |
| 01048177 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 170689 (New York) | Primary |
| Provider Name | Anthony J Antonucci |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811007743 PECOS PAC ID: 3779562574 Enrollment ID: I20040715000881 |
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