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1124310164
DOMINIC A BRACCO
MINEOLA, NY
NPI
1124310164
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
(Licence: NY 013894)
Enumeration Date
2011-05-10
Last Update Date
2011-05-10
Business Address
Mr. DOMINIC A BRACCO RPAC
259 1ST ST
MINEOLA, NY 11501-3957
Phone number: 516-663-8312
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Mailing Address
Mr. DOMINIC A BRACCO RPAC
259 1ST ST
MINEOLA, NY 11501-3957
Phone number: 516-663-8312
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