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General NPI Number Information
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NPI Number | 1881205805
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Entity Type | Individual
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Provider Name | DEBRA DENISE GIULIETTI
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Gender | Female
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Dates
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Enumeration Date | 08/13/2020
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Last Update Date | 01/12/2022
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Provider Practice Location Address
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Address Line | 101 NICOLLS RD # T16-030
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City | STONY BROOK
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State | NY
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Zip | 11794-6401
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Country | US
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Telephone | 631-358-4760
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Fax |
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Provider Business Mailing Address
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Address Line | 101 NICOLLS RD # T16-030
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City | STONY BROOK
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State | NY
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Zip | 11794-8160
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Country | US
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Telephone | 631-358-4760
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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 | 309850
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License Number State | NY
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