Vaccariello, Charles John

Vaccariello, Charles John is an sole proprietor health care provider with primary practice located at 2092 Jericho Tpke Ste 5 , Commack NY 11725-3008. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Urology, Suppliers / Non-Pharmacy Dispensing Site, Allopathic & Osteopathic Physicians / Obesity Medicine. Allopathic & Osteopathic Physicians / Obesity Medicine is his primary health care specialty. Vaccariello, Charles John can be contacted via phone (631) 343-7611.

Contact Information

Primary practice address
2092 Jericho Tpke Ste 5 Commack NY 11725-3008
Phone: (631) 343-7611
Fax: (631) 343-7612
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X 104837 New York
Suppliers / Non-Pharmacy Dispensing Site 332900000X 104837 New York
Allopathic & Osteopathic Physicians / Obesity Medicine 207QB0002X 104837 New York

Profile Details

NPI number 1932275963
LBN Legal business name Vaccariello, Charles John
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 28th, 2006
Last updated Jul 21st, 2022 - about 3 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932275963 NPPES
New York MEDICAID 00631190

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