Provider Demographics
NPI:1710195771
Name:PICONE, ANDREW VA (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:VA
Last Name:PICONE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-8858
Mailing Address - Country:US
Mailing Address - Phone:212-529-5432
Mailing Address - Fax:212-529-7258
Practice Address - Street 1:24 5TH AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-8858
Practice Address - Country:US
Practice Address - Phone:212-529-5432
Practice Address - Fax:212-529-7258
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY398061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice