Most Relevant Information
Provider Data
| NPI Number: | 1003642521 |
| Provider Name: | TRICIA SIMONE FAMILUSI |
| Entity Type: | Individual |
| Taxonomy Code: | 163WP0809X |
| Specialty: | Registered Nurse |
| License Number: | 441773 |
Most Important Dates
| Enumeration Date: | 09/11/2024 |
| Last Updated: | 09/11/2024 |
Provider Practice Location
2146 JACKSON AVE
SEAFORD
NY
117832606
Practice Location Phone/Fax
| Phone: | 5166228888 |
| Fax: |
Provider Mailing Location
2146 JACKSON AVE
SEAFORD
NY
117832606
Provider Mailing Phone/Fax
| Phone: | 5166228888 |
| Fax: |