Nicole Ciavolella
Individual provider Active NPI Licensed Practical Nurse · Selden, NY
NPI 1891045720 · NPPES record last updated Sep 18, 2012
Key facts
- NPI
- 1891045720
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- 311229 (NY)
- Practice address
- 19 Washington Heights St
Selden, NY 11784-4013 - Phone
- (631) 839-9315
- NPI assigned
- Sep 18, 2012
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 311229 | NY | MD | Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 311229 | NY | Yes |
Addresses
Primary practice location
19 Washington Heights St
Selden, NY 11784-4013
Mailing address
19 Washington Heights St
Selden, NY 11784-4013
Other providers in Selden, NY
- Virginia Chapman
- Charles G Bleecher MDPC
- Gessie Charles
- Ramiz A Chaudhry
- Nathanael P Chevrin
- Sherri Ciccariello
- Deborah Rose Cincotta
- City Medical of Upper East Side, PLLC
- City Medical of Upper East Side, PLLC
- Melissa Ann Clayton
All providers in Selden, NY · Licensed Practical Nurse 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 18, 2012. 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.