Individual
KIMBERLY CIACCIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10101 ROCKAWAY BLVD, OZONE PARK, NY 11417-2228
(917) 566-9440
Mailing address
10101 ROCKAWAY BLVD, OZONE PARK, NY 11417-2228
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
687399
NY
363LP0200X
Pediatric Nurse Practitioner
Primary
382611
NY
Other
Enumeration date
07/07/2015
Last updated
07/06/2016
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