Stefanie Buccellato
Individual provider Active NPI Early Intervention Provider Agency · Shirley, NY
NPI 1740957422 · NPPES record last updated Sep 7, 2021
Key facts
- NPI
- 1740957422
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Early Intervention Provider Agency 252Y00000X
- Practice address
- 434 Sleepy Hollow Dr
Shirley, NY 11967-1251 - Phone
- (631) 834-5431
- NPI assigned
- Aug 30, 2021
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Early Intervention Provider Agency | 252Y00000X | Yes |
Addresses
Primary practice location
434 Sleepy Hollow Dr
Shirley, NY 11967-1251
Mailing address
434 Sleepy Hollow Dr
Shirley, NY 11967-1251
Phone (631) 834-5431
Other providers in Shirley, NY
- Tracey Bracco
- Jesse Brand
- Shannon Marie Brennan
- Gina Bridges
- Christopher Brodie
- Diego Fernando Bustamante Jr.
- Francesca Butler
- Susan Byrne
- Jessica Nicole Cacace
- Samantha Cairo
All providers in Shirley, NY · Early Intervention Provider Agency in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 7, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.