| Doctor Name: | JACOB VECCHIO |
| NPI Number: | 1023481611 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | 000224915 |
| Business Practice Address: | 1 Leo Moss Dr Olean, NY - 147601156 |
| Business Phone Number: | 7163738040 |
| Business Fax Number: | 7167013728 |
| Mailing Address: | 1 Leo Moss Dr, OLEAN |
| State: | NY |
| Postal Code: | 147601156 |
| Phone Number: | 7163738040 |
| Fax Number: | 7167013728 |
| NPI Enumeration Date: | 11/05/2015 |
| NPI Last Update Date: | 11/05/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 000224915 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |