Provider Demographics
NPI:1366587776
Name:SACCOCCIO, JOSEPH RONALD (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:RONALD
Last Name:SACCOCCIO
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
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Mailing Address - Street 1:140 CHARLES ST APT 16B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10014-6516
Mailing Address - Country:US
Mailing Address - Phone:212-675-6238
Mailing Address - Fax:
Practice Address - Street 1:590 AVENUE OF THE AMERICAS
Practice Address - Street 2:12TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-2019
Practice Address - Country:US
Practice Address - Phone:212-886-4053
Practice Address - Fax:212-206-4133
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY153207208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics