Lacqua, Michael Jude
Lacqua, Michael Jude is an individual health care provider with primary practice located at 2372 Victory Blvd , Staten Island NY 10314-6607. He recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic Surgery, which is considered as his primary health care specialty. Lacqua, Michael Jude can be contacted via phone (718) 761-3700.Contact Information
Primary practice address
2372 Victory Blvd
Staten Island NY 10314-6607
Phone: (718) 761-3700
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Plastic Surgery | 208200000X | 192446 | New York |
Profile Details
| NPI number | 1992753883 |
|---|---|
| LBN Legal business name | Lacqua, Michael Jude |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 4th, 2006 |
| Last updated | Mar 31st, 2008 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1992753883 | NPPES |
| New York | MEDICAID | 01710118 |
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