| Doctor Name: | ROBERTO ANTONACCI |
| NPI Number: | 1457302788 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 216325 |
| Business Practice Address: | 2780 Middle Country Rd Suite 210 Lake Grove, NY - 117552124 |
| Business Phone Number: | 6315884500 |
| Business Fax Number: | 6315884595 |
| Mailing Address: | 2780 Middle Country Rd, Suite 210 LAKE GROVE |
| State: | NY |
| Postal Code: | 117552124 |
| Phone Number: | 6315884500 |
| Fax Number: | 6315884595 |
| NPI Enumeration Date: | 05/12/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085R0001X |
| License Number: | 216325 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Radiation Oncology |
| Taxonomy Definition: | A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. |