Provider Demographics
NPI:1336732056
Name:SACCOMANNO PODIATRY PLLC
Entity Type:Organization
Organization Name:SACCOMANNO PODIATRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ROSARIO
Authorized Official - Middle Name:
Authorized Official - Last Name:SACCOMANNO
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:631-689-0202
Mailing Address - Street 1:35 SHORE RD
Mailing Address - Street 2:
Mailing Address - City:EAST SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733-3920
Mailing Address - Country:US
Mailing Address - Phone:631-689-0202
Mailing Address - Fax:631-689-2686
Practice Address - Street 1:35 SHORE RD
Practice Address - Street 2:
Practice Address - City:EAST SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733-3920
Practice Address - Country:US
Practice Address - Phone:631-689-0202
Practice Address - Fax:631-689-2686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-12
Last Update Date:2021-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty