Provider Demographics
NPI:1801365176
Name:SACCUCCIMORANO, MARIA GABRIELLE (RN)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:GABRIELLE
Last Name:SACCUCCIMORANO
Suffix:
Gender:F
Credentials:RN
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Mailing Address - Street 1:ELIZABETH ANN CLUNE MONTESSORI SCHOOL OF ITHACA
Mailing Address - Street 2:120 E KING RD
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850
Mailing Address - Country:US
Mailing Address - Phone:607-277-7335
Mailing Address - Fax:607-277-0251
Practice Address - Street 1:ELIZABETH ANN CLUNE MONTESSORI SCHOOL OF ITHACA
Practice Address - Street 2:120 E KING RD
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850
Practice Address - Country:US
Practice Address - Phone:607-277-7335
Practice Address - Fax:607-277-0251
Is Sole Proprietor?:No
Enumeration Date:2018-11-16
Last Update Date:2018-11-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY22671522163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool