Provider Demographics
NPI:1043055783
Name:SCUDIERO, MARIA REGINA (NURSE PRACTICIONER)
Entity type:Individual
Prefix:MS
First Name:MARIA
Middle Name:REGINA
Last Name:SCUDIERO
Suffix:
Gender:
Credentials:NURSE PRACTICIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:265 MASON AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10305-3412
Mailing Address - Country:US
Mailing Address - Phone:917-293-8000
Mailing Address - Fax:718-887-2280
Practice Address - Street 1:213 BAY 8TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11228-3808
Practice Address - Country:US
Practice Address - Phone:917-293-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-25
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY354586363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily