Provider Demographics
NPI:1902796006
Name:MONDRONE, NICOLE SOLIMINE
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:SOLIMINE
Last Name:MONDRONE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92 DOVECOTE LN
Mailing Address - Street 2:
Mailing Address - City:COMMACK
Mailing Address - State:NY
Mailing Address - Zip Code:11725-2748
Mailing Address - Country:US
Mailing Address - Phone:516-492-7066
Mailing Address - Fax:
Practice Address - Street 1:5000 BUSINESS CENTER DR STE 500
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-7423
Practice Address - Country:US
Practice Address - Phone:912-295-4956
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-09
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000164103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst