Provider Demographics
NPI:1093049249
Name:PITCHER, DANIELLE DESIREE (RN)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:DESIREE
Last Name:PITCHER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:708 IRVING AVE
Mailing Address - Street 2:
Mailing Address - City:ENDICOTT
Mailing Address - State:NY
Mailing Address - Zip Code:13760-2116
Mailing Address - Country:US
Mailing Address - Phone:607-765-2847
Mailing Address - Fax:
Practice Address - Street 1:708 IRVING AVE
Practice Address - Street 2:
Practice Address - City:ENDICOTT
Practice Address - State:NY
Practice Address - Zip Code:13760-2116
Practice Address - Country:US
Practice Address - Phone:607-765-2847
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-21
Last Update Date:2009-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY603287163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse