Most Relevant Information
Provider Data
| NPI Number: | 1003457094 |
| Provider Name: | NICOLE LIVESCU NP |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | 345087 |
Most Important Dates
| Enumeration Date: | 10/01/2019 |
| Last Updated: | 10/01/2019 |
Provider Practice Location
35 W 45TH ST FL 6
NEW YORK
NY
100364903
Practice Location Phone/Fax
| Phone: | 2124008384 |
| Fax: |
Provider Mailing Location
4739 40TH ST APT 4D
SUNNYSIDE
NY
111044036
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |