Provider Demographics
NPI:1932484227
Name:LOCASCIO, RISA J (RN)
Entity Type:Individual
Prefix:
First Name:RISA
Middle Name:J
Last Name:LOCASCIO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 DAELL LN
Mailing Address - Street 2:
Mailing Address - City:CENTEREACH
Mailing Address - State:NY
Mailing Address - Zip Code:11720-4303
Mailing Address - Country:US
Mailing Address - Phone:631-981-2416
Mailing Address - Fax:
Practice Address - Street 1:12 DAELL LN
Practice Address - Street 2:
Practice Address - City:CENTEREACH
Practice Address - State:NY
Practice Address - Zip Code:11720-4303
Practice Address - Country:US
Practice Address - Phone:631-981-2416
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-18
Last Update Date:2011-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY254006-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse