| Doctor Name: | CARMELO ANTHONY PUCCIO |
| NPI Number: | 1023070976 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 145841 |
| Business Practice Address: | 19 Bradhurst Ave Suite 2100 Hawthorne, NY - 105322140 |
| Business Phone Number: | 9144938375 |
| Business Fax Number: | 9143471832 |
| Mailing Address: | Po Box 69, HAWTHORNE |
| State: | NY |
| Postal Code: | 105320069 |
| Phone Number: | 9144938375 |
| Fax Number: | 9143471832 |
| NPI Enumeration Date: | 04/05/2006 |
| NPI Last Update Date: | 10/14/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207RH0003X |
| License Number: | 145841 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NY |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Internal Medicine |
| Taxonomy Specialization: | Hematology & Oncology |
| Taxonomy Definition: | An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |