Provider Demographics
NPI:1164867776
Name:DIGREGORIO, DANIELLE J (RN)
Entity Type:Individual
Prefix:MS
First Name:DANIELLE
Middle Name:J
Last Name:DIGREGORIO
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 1:1600 GRAND AVE
Mailing Address - Street 2:APT J-3
Mailing Address - City:NORTH BALDWIN
Mailing Address - State:NY
Mailing Address - Zip Code:11510-1885
Mailing Address - Country:US
Mailing Address - Phone:516-808-0223
Mailing Address - Fax:
Practice Address - Street 1:1600 GRAND AVE
Practice Address - Street 2:APT J-3
Practice Address - City:NORTH BALDWIN
Practice Address - State:NY
Practice Address - Zip Code:11510-1885
Practice Address - Country:US
Practice Address - Phone:516-808-0223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-08
Last Update Date:2013-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY668018-01163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse