Individual
MRS. TAMARA B NICOLETTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
182 SOUTHAVEN AVE, MEDFORD, NY 11763-4056
(631) 681-2777
Mailing address
182 SOUTHAVEN AVE, MEDFORD, NY 11763-4056
(631) 681-2777
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
$$$$$$$$$
NY
Other
Enumeration date
08/10/2024
Last updated
08/10/2024
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