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:
Health care specialties
Specialty | Code | License # | 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 2 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 | 1932275963 | NPPES |
New York | MEDICAID | 00631190 |
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