Individual
JANICE IANNUCCI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
71 N BROADWAY, HICKSVILLE, NY 11801-2942
(516) 938-0020
(516) 470-1475
Mailing address
71 N BROADWAY, HICKSVILLE, NY 11801-2942
(516) 938-0020
(516) 470-1475
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F304305
NY
Other
Enumeration date
10/15/2009
Last updated
10/15/2009
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