Individual
NICOLE LADD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
285 W MAIN ST, SUITE 104, SAYVILLE, NY 11782-2540
(631) 563-8190
(631) 563-8194
Mailing address
45 REASEARCH WAY, STONY BROOK CHILDRENS SERVICES, UFPC, EAST SETAUKET, NY 11733
(631) 675-2125
(631) 675-2624
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
542820
NY
363LP0200X
Pediatric Nurse Practitioner
Primary
381989
NY
Other
Enumeration date
08/26/2009
Last updated
10/07/2019
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