Provider Demographics
NPI:1104188770
Name:ALBERICI, JOANN MARIE (MA)
Entity Type:Individual
Prefix:MRS
First Name:JOANN
Middle Name:MARIE
Last Name:ALBERICI
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:228 DARE RD
Mailing Address - Street 2:
Mailing Address - City:SELDEN
Mailing Address - State:NY
Mailing Address - Zip Code:11784-1406
Mailing Address - Country:US
Mailing Address - Phone:631-320-1362
Mailing Address - Fax:
Practice Address - Street 1:228 DARE RD
Practice Address - Street 2:
Practice Address - City:SELDEN
Practice Address - State:NY
Practice Address - Zip Code:11784-1406
Practice Address - Country:US
Practice Address - Phone:631-320-1362
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-11
Last Update Date:2012-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist