Provider Demographics
NPI:1922366798
Name:VERON, NICOLA ODETTE (REGISTERED NURSE)
Entity Type:Individual
Prefix:MISS
First Name:NICOLA
Middle Name:ODETTE
Last Name:VERON
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4429 DE REIMER AVE
Mailing Address - Street 2:PH
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10466
Mailing Address - Country:US
Mailing Address - Phone:646-305-7547
Mailing Address - Fax:
Practice Address - Street 1:4429 DE REIMER AVE
Practice Address - Street 2:PH
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10466
Practice Address - Country:US
Practice Address - Phone:646-305-7547
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-30
Last Update Date:2012-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY638567-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse