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General NPI Number Information
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NPI Number | 1790874097
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Entity Type | Individual
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Provider Name | NICOLETTE J SACCO-BROWN OD
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Gender | Female
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Dates
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Enumeration Date | 10/12/2006
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Last Update Date | 12/27/2007
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Provider Practice Location Address
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Address Line | 183 HEALY BLVD
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City | HUDSON
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State | NY
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Zip | 12534-1509
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Country | US
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Telephone | 518-828-8733
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Fax | 518-828-4898
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Provider Business Mailing Address
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Address Line | 183 HEALY BLVD
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City | HUDSON
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State | NY
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Zip | 12534-1509
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Country | US
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Telephone | 518-828-8733
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Fax | 518-828-4898
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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 | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | TUV 4816
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License Number State | NY
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