Molleen M Dematteo, RN
Registered Nurse, School in Ithaca, NY. Individual provider (NPI-1).
NPI number1740539600
StatusActive
Last updated in NPPESSep 6, 2012
Details
- NPI
- 1740539600
- Entity type
- Individual (NPI-1)
- Name
- Molleen M Dematteo
- Credential
- RN
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Sep 6, 2012
- Last updated
- Sep 6, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 163WS0200X | Registered Nurse, School | 506075 | NY | Yes |
Practice location
214 Elmira RdIthaca, NY 14850-5302
Phone 607-273-9015
Mailing address
101 Cedar LnGroton, NY 13073-1311
Phone 607-898-4703
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