Provider Demographics
NPI:1982044772
Name:VARRICCHIO, JOAN L (RN)
Entity Type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:L
Last Name:VARRICCHIO
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 1:84 HY VUE TER
Mailing Address - Street 2:
Mailing Address - City:COLD SPRING
Mailing Address - State:NY
Mailing Address - Zip Code:10516-3913
Mailing Address - Country:US
Mailing Address - Phone:845-591-6903
Mailing Address - Fax:
Practice Address - Street 1:84 HY VUE TER
Practice Address - Street 2:
Practice Address - City:COLD SPRING
Practice Address - State:NY
Practice Address - Zip Code:10516-3913
Practice Address - Country:US
Practice Address - Phone:845-591-6903
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-26
Last Update Date:2013-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY256100163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse