Annette Iacono

Primary specialty

Clinical Pathology/Laboratory Medicine PhysicianTaxonomy code 207ZP0105X

License

00472A Issued in PA

Practice address

2901 Dutton Mill Rd
Aston, PA 19014-2849

Phone

(610) 872-6466

Fax

(610) 872-7628

NPI assigned

Jul 23, 2021

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Brookside Clinical Laboratory Inc

  • Clinical Medical Laboratory
  • Aston, PA
  • NPI 1629047436
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1626998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626998400000",
    "number": "1881267110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 DUTTON MILL RD",
            "city": "ASTON",
            "state": "PA",
            "postal_code": "190142849",
            "telephone_number": "610-872-6466",
            "fax_number": "610-872-7628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 DUTTON MILL RD",
            "city": "ASTON",
            "state": "PA",
            "postal_code": "190142849",
            "telephone_number": "610-872-6466",
            "fax_number": "610-872-7628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IACONO",
        "first_name": "ANNETTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-23",
        "last_updated": "2021-07-23",
        "certification_date": "2021-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0105X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": "PA",
            "license": "00472A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tamara Pruette Heacock, OTR/L
• Healing Hands of Gardenia LLC
• Hearts of Compassion
• Holcomb Behavioral Health Systems
• Hometech Therapies Inc
• Infinite Family Services
• Infucare RX, LLC
• Innovative Muscle Therapy and Pain Center LLC
• Allen Gordon Irons Jr., R.PH.
• Carl Dennis Jackson, D.M.D.

• Clinical Pathology/Laboratory Medicine Physician in Aston, PA
• Providers in Aston, PA by specialty
• Clinical Pathology/Laboratory Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.