Most Relevant Information
Provider Data
| NPI Number: | 1003204884 |
| Provider Name: | GINA CARUCCI |
| Entity Type: | Individual |
| Taxonomy Code: | 363AM0700X |
| Specialty: | Physician Assistant |
| License Number: | 0182841 |
Most Important Dates
| Enumeration Date: | 01/02/2015 |
| Last Updated: | 03/17/2022 |
Provider Practice Location
259 1ST ST
MINEOLA
NY
115013957
Practice Location Phone/Fax
| Phone: | 5166630333 |
| Fax: |
Provider Mailing Location
259 1ST ST
MINEOLA
NY
115013957
Provider Mailing Phone/Fax
| Phone: | 5166630333 |
| Fax: |