Nicole Rose Buccellato, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

305382 Issued in NY

Practice address

1505 Jerusalem Ave
North Merrick, NY 11566-1330

Phone

(516) 280-7502

NPI assigned

Jun 27, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1498521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1699295014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 JERUSALEM AVE",
            "city": "NORTH MERRICK",
            "state": "NY",
            "postal_code": "115661330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 JERUSALEM AVE",
            "city": "NORTH MERRICK",
            "state": "NY",
            "postal_code": "115661330",
            "telephone_number": "516-280-7502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCCELLATO",
        "first_name": "NICOLE",
        "middle_name": "ROSE",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-27",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "305382",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW YORK STATE",
            "identifier": "305382",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Delia Abitante, FNP
• Hugo Arenas, PT, DPT
• Bellmore Merrick CHSD
• Crystal Chiari, MA
• Jeanette Cigliano, MA CCC/SLP
• Rebecca Costa, OTR/L
• Darrell Crayton, MT
• Dr.John J. Mark and Dr. Judith L. Mark LLP

• Licensed Practical Nurse in North Merrick, NY
• Providers in North Merrick, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.