Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | 278958 | NY |
NPI | 1073870655 |
---|---|
Provider Name | Dr. Eileen Marie Nicoletti |
First Address | Rockville Centre, NY 11570-6202 |
Second Address | New York, NY 10065-6007 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2012 |
Last Update Date | 30/11/2018 |