Provider Demographics
NPI:1073556460
Name:CURCIO, MARIA PUANGCO (CDE, RDN, CND)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:PUANGCO
Last Name:CURCIO
Suffix:
Gender:F
Credentials:CDE, RDN, CND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 WEST MAIN STREET
Mailing Address - Street 2:HEMODIALYSIS
Mailing Address - City:PATCHOGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11772
Mailing Address - Country:US
Mailing Address - Phone:631-687-4188
Mailing Address - Fax:631-687-2879
Practice Address - Street 1:109 WEST MAIN STREET
Practice Address - Street 2:HEMODIALYSIS
Practice Address - City:PATCHOGUE
Practice Address - State:NY
Practice Address - Zip Code:11772
Practice Address - Country:US
Practice Address - Phone:631-687-4188
Practice Address - Fax:631-687-2879
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-14
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY20720275174H00000X
NY009172133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
No174H00000XOther Service ProvidersHealth EducatorGroup - Single Specialty