Provider Demographics
NPI:1003591868
Name:GULINO, NICOLE P (RN, BSN)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:P
Last Name:GULINO
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 HEWITT BLVD
Mailing Address - Street 2:
Mailing Address - City:CENTER MORICHES
Mailing Address - State:NY
Mailing Address - Zip Code:11934-3008
Mailing Address - Country:US
Mailing Address - Phone:631-294-3147
Mailing Address - Fax:
Practice Address - Street 1:85 HEWITT BLVD
Practice Address - Street 2:
Practice Address - City:CENTER MORICHES
Practice Address - State:NY
Practice Address - Zip Code:11934-3008
Practice Address - Country:US
Practice Address - Phone:631-294-3147
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-20
Last Update Date:2023-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY797335163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse