Provider Demographics
NPI:1093036394
Name:PIEZZO, TERRI ANNE (ANP)
Entity Type:Individual
Prefix:MRS
First Name:TERRI
Middle Name:ANNE
Last Name:PIEZZO
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 JAMES ST
Mailing Address - Street 2:
Mailing Address - City:BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11702-2808
Mailing Address - Country:US
Mailing Address - Phone:631-321-8337
Mailing Address - Fax:
Practice Address - Street 1:38 JAMES ST
Practice Address - Street 2:
Practice Address - City:BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11702-2808
Practice Address - Country:US
Practice Address - Phone:631-321-8337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-21
Last Update Date:2010-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY305353363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health