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:631-864-3338
Mailing Address - Street 1:19 HARNED RD
Mailing Address - Street 2:
Mailing Address - City:COMMACK
Mailing Address - State:NY
Mailing Address - Zip Code:11725-3513
Mailing Address - Country:US
Mailing Address - Phone:631-864-3338
Mailing Address - Fax:631-864-8166
Practice Address - Street 1:19 HARNED RD
Practice Address - Street 2:
Practice Address - City:COMMACK
Practice Address - State:NY
Practice Address - Zip Code:11725-3513
Practice Address - Country:US
Practice Address - Phone:631-864-3338
Practice Address - Fax:631-864-8166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-12
Last Update Date:2024-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty