Individual
MRS. JUDITH ELLENA GROSSO SICKLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP-PC, RN
Contact information
Practice address
301 MANCHESTER RD STE 105, POUGHKEEPSIE, NY 12603-2895
(845) 452-1700
Mailing address
70 KILBAR ROAD, HUDSON, NY 12534
(518) 221-9122
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
616136
NY
163WH0200X
Home Health Registered Nurse
616136-1
NY
163WP0200X
Pediatric Registered Nurse
616136-1
NY
363LP0200X
Pediatric Nurse Practitioner
Primary
F383023-01
NY
363LP0222X
Critical Care Pediatric Nurse Practitioner
F383023-01
NY
Other
Enumeration date
06/04/2010
Last updated
03/20/2023
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