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NPI Code Detail

MEDICARE: NICOLE M PASSARETTI PMHNP

MEDICARE: NICOLE M PASSARETTI PMHNP
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner403659NY

General Provider Information

NPI Number : 1477136075
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE M PASSARETTI PMHNP
Provider Business Mailing Address
First Line : 1 BLUE HILL PLZ STE 1509
Second Line :
City : PEARL RIVER
State : NY
Zip : 10965-3165
Country : US
Telephone Number : 845-448-9654
Fax Number : 845-285-9254
Provider Business Practice Location Address
First Line : 1 BLUE HILL PLZ STE 1509
Second Line :
City : PEARL RIVER
State : NY
Zip : 10965-3165
Country : US
Telephone Number : 845-448-9654
Fax Number : 845-285-9254
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/30/2021
Last Update Date : 06/02/2025

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