Provider Demographics
NPI:1841549433
Name:ZUCKOFF, ELIZABETH ANN (LPN)
Entity type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:ANN
Last Name:ZUCKOFF
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MS
Other - First Name:ELIZABETH
Other - Middle Name:ANN
Other - Last Name:FALCIANO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:33 ARMSTRONG CIRCLE
Mailing Address - Street 2:
Mailing Address - City:ALTAMONT
Mailing Address - State:NY
Mailing Address - Zip Code:12009
Mailing Address - Country:US
Mailing Address - Phone:518-861-1179
Mailing Address - Fax:
Practice Address - Street 1:33 ARMSTRONG CIRCLE
Practice Address - Street 2:
Practice Address - City:ALTAMONT
Practice Address - State:NY
Practice Address - Zip Code:12009
Practice Address - Country:US
Practice Address - Phone:518-861-1179
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-29
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY260236-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse