Jack Facciolo is a Specialist in Rio Grande, New Jersey. Jack Facciolo practices all healthcare services and medical treatments related to Specialist. The NPI Number for Jack Facciolo is 1558330076. The last update date is 2009-12-01.
Jack Facciolo's current location address is 1 Secluded Ln, Rio Grande, New Jersey. You can contact this provider via phone number 6093681952. The mailing address for Jack Facciolo is 1 Secluded Ln, Rio Grande, New Jersey. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jack Facciolo |
|---|---|
| Address | 1 Secluded Ln, Rio Grande, New Jersey |
| Phone Number | 6093681952 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | D.O. |
NPI Number Detail
| NPI Number | 1558330076 |
|---|---|
| Provider Enumeration Date | 2006-03-16 |
| Last Updated Date | 2009-12-01 |
Provider Mailing Address Detail
| Address | 1 Secluded Ln |
|---|---|
| City | Rio Grande |
| State | New Jersey (NJ) |
| Post Code | 82421546 |
| Phone Number | 6093681952 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Specialist |
|---|---|
| Taxonomy | 174400000X |
| Licence No | MB039210 |
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Definition: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1213261003 | NJ | CIGNA PPO NUMBER | |
| 2345005 | NJ | -- | |
| CMS005 | NJ | OXFORD PROVIDER NUMBER | |
| 1074056 | NJ | HORIZON NJ HEALTH NUMBER | |
| 825040 | NJ | CIGNA HMO NUMBER | |
| 90462000 | NJ | INDP BCBS PROVIDER NUMBER |
Post Comment/ Review Below
What is the unique provider identifier assigned to Jack Facciolo?
The Jack Facciolo has been issued the NPI (National Provider Identifier) 1558330076 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you please provide the complete physical location address of Jack Facciolo?
The Jack Facciolo is physically situated at 1 Secluded Ln, in the city of Rio Grande, state of NJ, with the postal code 82421546.
What is the area of specialization for Jack Facciolo, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Jack Facciolo is Specialist, and the corresponding taxonomy code that categorizes this area of expertise is 174400000X.
On what date did the Jack Facciolo receive the assignment of its 1558330076 from the Centers for Medicare & Medicaid Services?
The Jack Facciolo was issued its 1558330076 by the Centers for Medicare & Medicaid Services on 2006-03-16.
When was the Jack Facciolo's information last updated?
The Jack Facciolo's information was last updated on 2009-12-01.