Provider Demographics
NPI:1497119473
Name:CONCA, SAVERIO FRANCIS (MD)
Entity Type:Individual
Prefix:DR
First Name:SAVERIO
Middle Name:FRANCIS
Last Name:CONCA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29449 BROWN CT
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48135-2309
Mailing Address - Country:US
Mailing Address - Phone:845-616-7397
Mailing Address - Fax:
Practice Address - Street 1:731 HWY 35 UNIT G
Practice Address - Street 2:
Practice Address - City:OCEAN
Practice Address - State:NJ
Practice Address - Zip Code:07712-4765
Practice Address - Country:US
Practice Address - Phone:732-455-8444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-06
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA10703800207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0711977Medicaid