Provider Demographics
NPI:1275010100
Name:BELLUCCI, CORRINNE (LPN)
Entity Type:Individual
Prefix:
First Name:CORRINNE
Middle Name:
Last Name:BELLUCCI
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 BELMONT PL
Mailing Address - Street 2:
Mailing Address - City:HICKSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11801-1117
Mailing Address - Country:US
Mailing Address - Phone:516-652-5651
Mailing Address - Fax:877-614-4949
Practice Address - Street 1:4 BELMONT PL
Practice Address - Street 2:
Practice Address - City:HICKSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11801-1117
Practice Address - Country:US
Practice Address - Phone:516-652-5651
Practice Address - Fax:877-614-4949
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-24
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY332047164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse