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Contact Information

STEPHANIE NUCCI II, PA
635 BELLE TERRE RD
SUITE #204
PORT JEFFERSON, NY11777-1935
 Phone: 631-474-0008
 Fax: 631-474-0224
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgical

363AS0400X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for STEPHANIE NUCCI II · (Female)

NPI # 1629259668
Status Active
Credentials PA (Physician Assistant)
Entity Individual
Enumeration date 11/19/2007
Last updated 02/01/2010 - About 16 years ago
Sole proprietor 1 No
Identifiers
  • NY License # 009608
Hospital affiliation(s)
  • SOUTHSIDE HOSPITAL - (Acute Care)
    301 EAST MAIN STREET
    BAY SHORE, NY 11706
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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