Individual
DANIELLE NICOLE SHATTUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
260 E MIDDLE COUNTRY RD STE 208, SMITHTOWN, NY 11787-2925
(631) 863-3223
Mailing address
260 E MIDDLE COUNTRY RD STE 208, SMITHTOWN, NY 11787-2925
(631) 863-3223
(631) 863-3334
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F311302-01
NY
Other
Enumeration date
07/06/2023
Last updated
10/03/2024
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