Provider Demographics
NPI:1710461140
Name:DANSEGLIO, MARIA LETICIA (RN)
Entity Type:Individual
Prefix:MRS
First Name:MARIA LETICIA
Middle Name:
Last Name:DANSEGLIO
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 1:492 BOHEMIA PKWY
Mailing Address - Street 2:
Mailing Address - City:SAYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11782-3302
Mailing Address - Country:US
Mailing Address - Phone:631-563-4505
Mailing Address - Fax:
Practice Address - Street 1:492 BOHEMIA PKWY
Practice Address - Street 2:
Practice Address - City:SAYVILLE
Practice Address - State:NY
Practice Address - Zip Code:11782-3302
Practice Address - Country:US
Practice Address - Phone:631-563-4505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-21
Last Update Date:2018-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY423988-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse