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General NPI Number Information
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NPI Number | 1790327062
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Entity Type | Individual
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Provider Name | NICOLETTA GUERRIER NURSE PRACTITIONER
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Gender | Female
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Dates
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Enumeration Date | 10/08/2019
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Last Update Date | 10/09/2023
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Provider Practice Location Address
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Address Line | 2366 DUTCH BROADWAY
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City | ELMONT
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State | NY
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Zip | 11003-3508
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Country | US
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Telephone | 516-488-8595
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Fax | 516-488-8599
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Provider Business Mailing Address
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Address Line | 2366 DUTCH BROADWAY
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City | ELMONT
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State | NY
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Zip | 11003-3508
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Country | US
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Telephone | 516-488-8595
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Fax | 516-488-8599
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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 | 163WC0400X
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Taxonomy Name | Case Management Registered Nurse
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License Number | 5955951
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | F311312-01
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License Number State | NY
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