Individual
MRS. TARA FLOCCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, NP
Contact information
Practice address
101 NICOLLS RD, STONY BROOK, NY 11794-0001
(314) 445-4376
Mailing address
101 NICOLLS RD, STONY BROOK, NY 11794-0001
(314) 445-4376
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
516300-1
NY
363LP0200X
Pediatric Nurse Practitioner
Primary
F382313-1
NY
Other
Enumeration date
04/22/2008
Last updated
04/29/2022
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