Provider Demographics
NPI:1720200199
Name:NUZZI, DINO FRANCIS
Entity Type:Individual
Prefix:
First Name:DINO
Middle Name:FRANCIS
Last Name:NUZZI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 WHITMORE LN
Mailing Address - Street 2:
Mailing Address - City:CORAM
Mailing Address - State:NY
Mailing Address - Zip Code:11727-1028
Mailing Address - Country:US
Mailing Address - Phone:631-474-0981
Mailing Address - Fax:
Practice Address - Street 1:16 WHITMORE LN
Practice Address - Street 2:
Practice Address - City:CORAM
Practice Address - State:NY
Practice Address - Zip Code:11727-1028
Practice Address - Country:US
Practice Address - Phone:631-474-0981
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY261025-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02004722Medicaid
NYR42541OtherEMPIRE PRIVITE PROVIDER