Provider Demographics
NPI:1891821195
Name:PUCCI, DARCIE L (RN, ATC)
Entity Type:Individual
Prefix:
First Name:DARCIE
Middle Name:L
Last Name:PUCCI
Suffix:
Gender:F
Credentials:RN, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 MCELWAIN AVE
Mailing Address - Street 2:
Mailing Address - City:COHOES
Mailing Address - State:NY
Mailing Address - Zip Code:12047-2420
Mailing Address - Country:US
Mailing Address - Phone:518-237-8609
Mailing Address - Fax:
Practice Address - Street 1:515 LOUDON RD
Practice Address - Street 2:
Practice Address - City:LOUDONVILLE
Practice Address - State:NY
Practice Address - Zip Code:12211-1459
Practice Address - Country:US
Practice Address - Phone:518-783-2544
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000502-12255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer