Nicosia, Theresa Jeanne

Nicosia, Theresa Jeanne is an individual health care provider with primary practice located at 6 Park View Ln , Lake Grove NY 11755-1854. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Primary Care. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Nicosia, Theresa Jeanne can be contacted via phone (631) 467-8229.

Contact Information

Primary practice address
6 Park View Ln Lake Grove NY 11755-1854
Phone: (631) 467-8229
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X F334231-1 New York
Physician Assistants & Advanced Practice Nursing Providers / Primary Care 363LP2300X F334231 New York

Profile Details

NPI number 1710077821
LBN Legal business name Nicosia, Theresa Jeanne
Credentials RN MS FNP
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 13th, 2006
Last updated May 10th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710077821 NPPES
New York MEDICAID 02703515

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