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General NPI Number Information
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NPI Number | 1558760413
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Entity Type | Organization
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Legal Business Name | PATRICIA NICOLETTA
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Dates
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Enumeration Date | 08/17/2014
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Last Update Date | 08/17/2014
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Provider Practice Location Address
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Address Line | 103 W CEDARVIEW AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10306-1709
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Country | US
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Telephone | 718-351-3850
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Fax |
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Provider Business Mailing Address
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Address Line | 103 W CEDARVIEW AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10306-1709
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Country | US
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Telephone | 718-351-3850
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Fax |
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Authorized Official
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Title or Position | SENIOR OCCUPATIONAL THERAPIST
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Name | MRS. PATRICIA NICOLETTA
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Credential | OTR
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Telephone | 718-351-3850
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 283X00000X
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Taxonomy Name | Rehabilitation Hospital
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License Number | 002361
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License Number State | NY
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