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NPI Code Detail

MEDICARE: MS. DENISE MARIE NICOLETTI LMSW

MEDICARE: MS. DENISE MARIE NICOLETTI LMSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker073642NY

General Provider Information

NPI Number : 1255497517
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. DENISE MARIE NICOLETTI LMSW
Provider Business Mailing Address
First Line : 470 HALSTEAD AVE APT 2J
Second Line :
City : HARRISON
State : NY
Zip : 10528-3834
Country : US
Telephone Number : 914-646-3907
Fax Number :
Provider Business Practice Location Address
First Line : 277 NORTH AVE
Second Line : 3RD FLOOR
City : NEW ROCHELLE
State : NY
Zip : 10801-5103
Country : US
Telephone Number : 914-632-7600
Fax Number : 914-632-8837
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/29/2006
Last Update Date : 07/08/2007

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