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General NPI Number Information
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NPI Number | 1174028799
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Entity Type | Individual
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Provider Name | FILIPPA PETRUCCELLI NURSE PRACTITIONER
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Gender | Female
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Dates
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Enumeration Date | 03/26/2018
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Last Update Date | 03/06/2025
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Provider Practice Location Address
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Address Line | 101 LAUREL RD
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City | EAST NORTHPORT
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State | NY
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Zip | 11731-1415
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Country | US
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Telephone | 631-930-9399
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Fax |
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Provider Business Mailing Address
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Address Line | 243 CENTRAL PARK RD
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City | PLAINVIEW
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State | NY
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Zip | 11803-2030
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Country | US
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Telephone | 857-205-9747
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | F30806601
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License Number State | NY
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