Provider Demographics
NPI:1740467380
Name:CARCIONE, PHILIP JOSEPH (BS)
Entity type:Individual
Prefix:MR
First Name:PHILIP
Middle Name:JOSEPH
Last Name:CARCIONE
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:738 FOOTE AVE
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:14701-8201
Mailing Address - Country:US
Mailing Address - Phone:716-483-1416
Mailing Address - Fax:716-484-7767
Practice Address - Street 1:738 FOOTE AVE
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:NY
Practice Address - Zip Code:14701-8201
Practice Address - Country:US
Practice Address - Phone:716-483-1416
Practice Address - Fax:716-484-7767
Is Sole Proprietor?:No
Enumeration Date:2008-01-25
Last Update Date:2008-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY28447183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist