Individual
NICOLE DELVECCHIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
931 HALLOCK AVE, PORT JEFFERSON STATION, NY 11776-1228
(631) 331-7200
Mailing address
210 WINDWARD CT N, PORT JEFFERSON, NY 11777-2333
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
557210-1
NY
363LA2200X
Adult Health Nurse Practitioner
Primary
F308477-1
NY
Other
Enumeration date
09/11/2017
Last updated
10/04/2018
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