Provider Demographics
NPI:1285833467
Name:D'ANTONA, JOSEPH A (LAC)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:A
Last Name:D'ANTONA
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:499 DEER PARK AVE
Mailing Address - Street 2:
Mailing Address - City:BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11702-1922
Mailing Address - Country:US
Mailing Address - Phone:631-376-2492
Mailing Address - Fax:631-669-4154
Practice Address - Street 1:672 N WELLWOOD AVE
Practice Address - Street 2:
Practice Address - City:LINDENHURST
Practice Address - State:NY
Practice Address - Zip Code:11757-1677
Practice Address - Country:US
Practice Address - Phone:631-376-2492
Practice Address - Fax:631-669-4154
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-17
Last Update Date:2008-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002974171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist