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General NPI Number Information
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NPI Number | 1407610330
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Entity Type | Individual
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Provider Name | PAMELA DADDINO
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Gender | Female
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Dates
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Enumeration Date | 02/12/2024
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Last Update Date | 02/12/2024
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Provider Practice Location Address
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Address Line | 100 PORT WASHINGTON BLVD
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City | ROSLYN
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State | NY
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Zip | 11576-1347
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Country | US
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Telephone | 516-562-6426
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Fax |
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Provider Business Mailing Address
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Address Line | 772 PLATO ST
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City | FRANKLIN SQUARE
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State | NY
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Zip | 11010-3335
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Country | US
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Telephone | 516-941-5008
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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 | 311537
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License Number State | NY
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