Provider Demographics
NPI:1447535315
Name:PUCCIA, KAREN S (RN)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:S
Last Name:PUCCIA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 CENTRAL AVENUE
Mailing Address - Street 2:
Mailing Address - City:CORTLAND
Mailing Address - State:NY
Mailing Address - Zip Code:13045-2746
Mailing Address - Country:US
Mailing Address - Phone:607-756-3401
Mailing Address - Fax:607-756-3483
Practice Address - Street 1:60 CENTRAL AVENUE
Practice Address - Street 2:
Practice Address - City:CORTLAND
Practice Address - State:NY
Practice Address - Zip Code:13045-2746
Practice Address - Country:US
Practice Address - Phone:607-756-3401
Practice Address - Fax:607-756-3483
Is Sole Proprietor?:No
Enumeration Date:2011-10-11
Last Update Date:2011-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY178942163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health