Provider Demographics
NPI:1962705194
Name:PUCCIO, CARMEN T (RN BSN)
Entity type:Individual
Prefix:
First Name:CARMEN
Middle Name:T
Last Name:PUCCIO
Suffix:
Gender:F
Credentials:RN BSN
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Mailing Address - Street 1:105 CLOVER DR
Mailing Address - Street 2:PUPIL PERSONNEL SERVICES- GREAT NECK PUBLIC SCHOOLS
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-1031
Mailing Address - Country:US
Mailing Address - Phone:516-441-4970
Mailing Address - Fax:516-441-4270
Practice Address - Street 1:105 CLOVER DR
Practice Address - Street 2:PUPIL PERSONNEL SERVICES- GREAT NECK PUBLIC SCHOOLS
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-1031
Practice Address - Country:US
Practice Address - Phone:516-441-4970
Practice Address - Fax:516-441-4270
Is Sole Proprietor?:No
Enumeration Date:2010-12-09
Last Update Date:2010-12-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY318610163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool