Provider Demographics
NPI:1225341258
Name:NUCCITELLI, KRISTINE SUZANNE (APN)
Entity Type:Individual
Prefix:MS
First Name:KRISTINE
Middle Name:SUZANNE
Last Name:NUCCITELLI
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 ROCHELLE PKWY
Mailing Address - Street 2:
Mailing Address - City:SADDLE BROOK
Mailing Address - State:NJ
Mailing Address - Zip Code:07663-4650
Mailing Address - Country:US
Mailing Address - Phone:201-880-5437
Mailing Address - Fax:
Practice Address - Street 1:1 VALLEY HEALTH PLZ
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-3628
Practice Address - Country:US
Practice Address - Phone:201-880-5437
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-19
Last Update Date:2010-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00275300363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health