Individual
MRS. TARA K PICCOLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, NNP-BC
Contact information
Practice address
101 NICOLLS RD, STONY BROOK, NY 11794-0001
(631) 444-2710
(631) 444-7865
Mailing address
22 RICHLEE ST, BLUE POINT, NY 11715-1517
(631) 374-0274
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
350558
NY
Other
Enumeration date
06/01/2022
Last updated
07/15/2025
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