Provider Demographics
NPI:1912257429
Name:MUSACCHIO, HILARY
Entity type:Individual
Prefix:
First Name:HILARY
Middle Name:
Last Name:MUSACCHIO
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 1:610 ORIOLE DR
Mailing Address - Street 2:
Mailing Address - City:ROAMING SHORES
Mailing Address - State:OH
Mailing Address - Zip Code:44084-9709
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:610 ORIOLE DR
Practice Address - Street 2:
Practice Address - City:ROAMING SHORES
Practice Address - State:OH
Practice Address - Zip Code:44084-9709
Practice Address - Country:US
Practice Address - Phone:440-645-3493
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-12
Last Update Date:2012-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN127597164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse