Individual
KATIE M. MARCUCCIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
326 WASHINGTON ST, DEPT OF ANESTHESIA, NORWICH, CT 06360-2740
(860) 889-8331
Mailing address
68 S SERVICE RD, SUITE 350, MELVILLE, NY 11747-2354
(516) 945-3034
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
04997
CT
367500000X
Certified Registered Nurse Anesthetist
RN263394
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110130192A
—
MA
Enumeration date
07/18/2012
Last updated
12/16/2020
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