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General NPI Number Information
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NPI Number | 1902391774
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Entity Type | Organization
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Legal Business Name | ELIZABETH PICCOLO NP IN PSYCHIATRY PLLC
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Dates
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Enumeration Date | 06/25/2018
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Last Update Date | 06/25/2018
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Provider Practice Location Address
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Address Line | 151 S MAIN ST STE 306
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City | NEW CITY
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State | NY
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Zip | 10956-3544
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Country | US
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Telephone | 845-639-0000
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Fax | 845-499-2537
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Provider Business Mailing Address
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Address Line | 151 S MAIN ST STE 306
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City | NEW CITY
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State | NY
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Zip | 10956-3544
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Country | US
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Telephone | 845-639-0000
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Fax | 845-499-2537
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Authorized Official
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Title or Position | PSYCHIATRIC MENTAL HEALTH NP
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Name | MS. ELIZABETH PICCOLO
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Credential | PMHNP-BC
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Telephone | 845-639-0000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 401153
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License Number State | NY
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