Individual provider · Type 1 NPI
Colleen Mary Defalco, NP
Adult Health Nurse Practitioner · Northport, NY
NPI number
1306043351
Active
Practice location
Va Medical Center, Dept Of Gastroenterology, 79 Middleville Road
Northport, NY 11768-2290
Fax (631) 486-6113
Mailing address
17 Colonial Dr
Smithtown, NY 11787-4212
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Adult Health Nurse Practitioner Primary | 363LA2200X | F300698-1 (NY) |
Adult Health Nurse Practitioner: Definition to come...
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About NPI 1306043351
Colleen Mary Defalco, NP's National Provider Identifier is 1306043351, issued on Jul 2, 2007. The primary taxonomy on file is Adult Health Nurse Practitioner (363LA2200X), and the practice location is in Northport, NY. The record was last updated on Jul 2, 2019.