Provider Demographics
NPI:1851164784
Name:CARLUCCI, DEBORAH ANGELA
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:ANGELA
Last Name:CARLUCCI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 EAST 125THST 2ND FLOOR
Mailing Address - Street 2:
Mailing Address - City:NEW YORK CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10035-1641
Mailing Address - Country:US
Mailing Address - Phone:212-774-3271
Mailing Address - Fax:
Practice Address - Street 1:103 E 125TH ST FL 2
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10035-0776
Practice Address - Country:US
Practice Address - Phone:212-774-3271
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-02
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY251981-01163WA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)