Provider Demographics
NPI:1477140390
Name:HUCZEL, DEANNA (NP)
Entity Type:Individual
Prefix:
First Name:DEANNA
Middle Name:
Last Name:HUCZEL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:DEANNA
Other - Middle Name:
Other - Last Name:HUCZEL-GAFNI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP
Mailing Address - Street 1:14116 70TH RD
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-1937
Mailing Address - Country:US
Mailing Address - Phone:917-715-0059
Mailing Address - Fax:
Practice Address - Street 1:14116 70TH RD
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11367-1937
Practice Address - Country:US
Practice Address - Phone:917-715-0059
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-26
Last Update Date:2020-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY307233363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health