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Individual

MS. MAURA E. PORRICOLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
1400 PELHAM PKWY S, ROOM 810, BRONX, NY 10461-1138
(718) 918-4781
Mailing address
1400 PELHAM PKWY S, ROOM 810, BRONX, NY 10461-1138
(718) 918-4781

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
380409
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02267398
NY
Enumeration date
09/16/2008
Last updated
09/16/2008
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