Individual
DANIELLE PEDDYCOART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5 BEACH RD, MASSAPEQUA, NY 11758-6614
(631) 655-5255
Mailing address
5 BEACH RD, MASSAPEQUA, NY 11758-6614
(631) 655-5255
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F349991-01
NY
Other
Enumeration date
08/18/2022
Last updated
08/18/2022
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