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General NPI Number Information
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NPI Number | 1982601175
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Entity Type | Individual
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Provider Name | PATRICIA A IACOVITTI NURSE PRACTITIONER
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Gender | Female
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Dates
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Enumeration Date | 07/01/2005
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 6937 WILLIAMS RD
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City | NIAGARA FALLS
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State | NY
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Zip | 14304-3022
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Country | US
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Telephone | 716-298-1107
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Fax | 716-298-5737
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Provider Business Mailing Address
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Address Line | 6937 WILLIAMS RD
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City | NIAGARA FALLS
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State | NY
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Zip | 14304-3022
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Country | US
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Telephone | 716-298-1107
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Fax | 716-298-5737
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | F3800366
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License Number State | NY
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