Colleen Mary Defalco, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

F300698-1 Issued in NY

Practice address

VA Medical Center, Dept of Gastroenterology
79 Middleville Road
Northport, NY 11768-2290

Phone

(631) 261-4400

Fax

(631) 486-6113

NPI assigned

Jul 2, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• St Catherine of Siena Medical Center

  • General Acute Care Hospital
  • Smithtown, NY
  • NPI 1245318609
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1183334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562025600000",
    "number": "1306043351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 COLONIAL DR",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117874212",
            "telephone_number": "631-864-7279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "VA MEDICAL CENTER, DEPT OF GASTROENTEROLOGY",
            "address_2": "79 MIDDLEVILLE ROAD",
            "city": "NORTHPORT",
            "state": "NY",
            "postal_code": "117682290",
            "telephone_number": "631-261-4400",
            "fax_number": "631-486-6113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEFALCO",
        "first_name": "COLLEEN",
        "middle_name": "MARY",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-02",
        "last_updated": "2019-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F300698-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather H Dale, LPN
• Susan Dalesandro, LCSW
• Helen M Daly, PMHNP-BC
• Kimberly Davidson, P.T.
• Sara G Dawber, LMSW
• Alison Sara Degennaro, PHARM.D.
• Shannon Delfino, RN
• Jeanine Michele Delgado, LCSW
• Laura Deluca, PH.D
• Jessica Dempsey, RN

• Adult Health Nurse Practitioner in Northport, NY
• Providers in Northport, NY by specialty
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.