Provider Demographics
NPI:1447330618
Name:LADISLAO VACCARO
Entity type:Organization
Organization Name:LADISLAO VACCARO
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LADISLAO
Authorized Official - Middle Name:D
Authorized Official - Last Name:VACCARO
Authorized Official - Suffix:
Authorized Official - Credentials:PEDORTHIST
Authorized Official - Phone:914-723-3116
Mailing Address - Street 1:138 E POST RD
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10601-5202
Mailing Address - Country:US
Mailing Address - Phone:914-723-3116
Mailing Address - Fax:914-725-4143
Practice Address - Street 1:138 E POST RD
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601-5202
Practice Address - Country:US
Practice Address - Phone:914-723-3116
Practice Address - Fax:914-725-4143
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2008-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY424040190001332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY4240190001Medicare NSC