Provider Demographics
NPI:1124365267
Name:ZARCONE, NICOLE L (MS, OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:L
Last Name:ZARCONE
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:L
Other - Last Name:POAT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, OTR/L
Mailing Address - Street 1:230 N EVERGREEN DR
Mailing Address - Street 2:
Mailing Address - City:SELDEN
Mailing Address - State:NY
Mailing Address - Zip Code:11784-2016
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:230 N EVERGREEN DR
Practice Address - Street 2:
Practice Address - City:SELDEN
Practice Address - State:NY
Practice Address - Zip Code:11784-2016
Practice Address - Country:US
Practice Address - Phone:631-325-6963
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-09
Last Update Date:2013-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017808225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics