| F Pacifico Pc | |
|
60 Queens St Syosset NY 11791-3058 | |
| (718) 702-7216 | |
| (831) 603-0351 |
| Full Name | F Pacifico Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 60 Queens St, Syosset, New York |
| Authorized Official Name and Position | Fernando Pacifico (PRESIDENT) |
| Authorized Official Contact | 7187027216 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| F Pacifico Pc 60 Queens St Syosset NY 11791-3058 Ph: (718) 702-7216 | F Pacifico Pc 60 Queens St Syosset NY 11791-3058 Ph: (718) 702-7216 |
| NPI Number | 1871776435 |
|---|---|
| Provider Enumeration Date | 12/06/2007 |
| Last Update Date | 04/27/2022 |
| Medicare PECOS PAC ID | 9931289147 |
|---|---|
| Medicare Enrollment ID | O20071231000041 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871776435 | NPI | - | NPPES |
| 00572472 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 141745 (New York) | Primary |
| Provider Name | Fernando Pacifico |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396858205 PECOS PAC ID: 6305926510 Enrollment ID: I20071231000028 |
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