Basic Information
Provider Information
NPI: 1710325287
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ACUNA
FirstName: JOSEPHINE
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: ACUNA
OtherFirstName: JOSIE
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 5
Mailing Information
Address1: 475 SEAVIEW AVE
Address2:  
City: STATEN ISLAND
State: NY
PostalCode: 103053436
CountryCode: US
TelephoneNumber: 7182261548
FaxNumber: 7182268447
Practice Location
Address1: 1501 N CAMPBELL AVE
Address2:  
City: TUCSON
State: AZ
PostalCode: 857243436
CountryCode: US
TelephoneNumber: 5206940111
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/06/2013
LastUpdateDate: 05/08/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/08/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000X52268AZY Allopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


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