Nicole Marie Vessalico
Specialist in Massapequa, NY. Individual provider (NPI-1).
NPI number1376972158
StatusActive
Last updated in NPPESMay 16, 2017
Details
- NPI
- 1376972158
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Nicole Marie Vessalico
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Nov 2, 2013
- Last updated
- May 16, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 174400000X | Specialist | 887871 | NY | Yes |
Practice location
17 Cottage DrMassapequa, NY 11758-6127
Phone 516-815-4285
Mailing address
17 Cottage DrMassapequa, NY 11758-6127
Phone 516-815-4285
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