Individual
MARY BURKE TRICOLLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, L.AC
Contact information
Practice address
900 BROADWAY, SUITE 404, NEW YORK, NY 10003-1210
(617) 877-1004
Mailing address
1 MORTON SQ, #3CE, NEW YORK, NY 10014-7800
(617) 877-1004
Taxonomy
Speciality
Code
Description
License number
State
163WX0200X
Oncology Registered Nurse
623668-1
NY
171100000X
Acupuncturist
Primary
004240-1
NY
Other
Enumeration date
03/01/2010
Last updated
03/01/2010
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