Provider Demographics
NPI:1396173258
Name:HASSELL, VALERIE (FNP)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:HASSELL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:VALERIE
Other - Middle Name:NICOLE
Other - Last Name:GUIDONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9 COMMUNITY RD
Mailing Address - Street 2:
Mailing Address - City:CORAM
Mailing Address - State:NY
Mailing Address - Zip Code:11727-3130
Mailing Address - Country:US
Mailing Address - Phone:631-278-1651
Mailing Address - Fax:
Practice Address - Street 1:732 SMITHTOWN BYP STE 200
Practice Address - Street 2:
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-5020
Practice Address - Country:US
Practice Address - Phone:631-278-1651
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-30
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY672112163W00000X
NYF350001363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse