Individual provider · Type 1 NPI
Jack Facciolo, DO
Specialist · Rio Grande, NJ
NPI number
1558330076
Active
Practice location
1 Secluded Ln
Rio Grande, NJ 08242-1546
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Specialist Primary | 174400000X | MB039210 (NJ) |
Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
Another provider at this address
About NPI 1558330076
Jack Facciolo, DO's National Provider Identifier is 1558330076, issued on Mar 16, 2006. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Rio Grande, NJ. The record was last updated on Dec 1, 2009.