Provider Demographics
NPI:1053363374
Name:PICCONE, JOSEPH S (NP)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:S
Last Name:PICCONE
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 ATTUCKS LN UNIT 1E
Mailing Address - Street 2:CAPE AND ISLANDS OCCUPATIONAL MEDICINE
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601-1809
Mailing Address - Country:US
Mailing Address - Phone:508-771-5773
Mailing Address - Fax:508-771-5774
Practice Address - Street 1:700 ATTUCKS LN UNIT 1E
Practice Address - Street 2:CAPE AND ISLANDS OCCUPATIONAL MEDICINE
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-1809
Practice Address - Country:US
Practice Address - Phone:508-771-5773
Practice Address - Fax:508-771-5774
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2013-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA176276363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0703788Medicaid
MANP1527OtherBCBS
NP1527Medicare ID - Type Unspecified
MA0703788Medicaid