Provider Demographics
NPI:1992748677
Name:CROCITTO, BARBARA E (NP)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:E
Last Name:CROCITTO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:E
Other - Last Name:SAUCHELLI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:GPO BOX 27686
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10087-7686
Mailing Address - Country:US
Mailing Address - Phone:888-220-1235
Mailing Address - Fax:865-450-9374
Practice Address - Street 1:120 MINEOLA BLVD
Practice Address - Street 2:STE 10 LOWER LEVEL
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-4073
Practice Address - Country:US
Practice Address - Phone:516-663-4510
Practice Address - Fax:516-663-3698
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2007-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF360238-1363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYS64663Medicare UPIN
NY97V191Medicare PIN