DR. Jack Facciolo, D.O.

NPI #1558330076 in Rio Grande, New Jersey

Provider Information

NPI Number: 1558330076
Entity Type: Individual
Name: DR. Jack Facciolo, D.O.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Specialist
Credential: D.O.
Enumeration Date: Mar 16, 2006
Last Updated: Dec 1, 2009

Practice Location

Address: 1 SECLUDED LN
City: Rio Grande
State: New Jersey
ZIP Code: 08242-1546
Phone: (609) 368-1952

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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