MEDICARE: DR. NICOLE MARIE DELAURO DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0103X	Foot & Ankle Surgery Podiatrist	N006303	NY

General Provider Information

NPI Number	:	1205075082
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NICOLE MARIE DELAURO DPM

Provider Business Mailing Address
First Line	:	438 ARDEN AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10312-2323
Country	:	US
Telephone Number	:	718-984-5900
Fax Number	:	718-227-0990

Provider Business Practice Location Address
First Line	:	438 ARDEN AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10312-2323
Country	:	US
Telephone Number	:	718-984-5900
Fax Number	:	718-227-0990

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/18/2009
Last Update Date	:	02/18/2009

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