Provider Demographics
NPI:1588192900
Name:CECCIO, CARMELA MARIE (LPN)
Entity Type:Individual
Prefix:MS
First Name:CARMELA
Middle Name:MARIE
Last Name:CECCIO
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MS
Other - First Name:CARMELA
Other - Middle Name:MARIE
Other - Last Name:CECCIO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPN
Mailing Address - Street 1:2 COLLABERG RD
Mailing Address - Street 2:
Mailing Address - City:STONY POINT
Mailing Address - State:NY
Mailing Address - Zip Code:10980-3409
Mailing Address - Country:US
Mailing Address - Phone:845-323-0250
Mailing Address - Fax:
Practice Address - Street 1:2 COLLABERG RD
Practice Address - Street 2:
Practice Address - City:STONY POINT
Practice Address - State:NY
Practice Address - Zip Code:10980-3409
Practice Address - Country:US
Practice Address - Phone:845-323-0250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-30
Last Update Date:2017-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY324996-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse