Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 26NJ00170400 | NJ |
N | 363LA2100X | Nurse Practitioner - Acute Care | 430355 | NY |
NPI | 1043483639 |
---|---|
Provider Name | Amy Dacillo-Curso |
First Address | Matawan, NJ 07747-3228 |
Second Address | New Brunswick, NJ 08901-1928 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2008 |
Last Update Date | 09/11/2009 |