Individual
ANTONIETTA DICICCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
12 STONY WOOD RD, EAST SETAUKET, NY 11733-1839
(516) 424-7474
Mailing address
12 STONY WOOD RD, EAST SETAUKET, NY 11733-1839
(516) 424-7474
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F351108-01
NY
Other
Enumeration date
02/13/2023
Last updated
02/13/2023
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