Individual provider · Type 1 NPI

Nicholas Martin Pascullo, LPN

Licensed Practical Nurse · Lake Ronkonkoma, NY

NPI number 1629590617 Active

Practice location

153 Lake Shore Rd
Lake Ronkonkoma, NY 11779-3157

Mailing address

60 Fairfax Dr
Coram, NY 11727-2317

Specialties and licenses

TaxonomyCodeLicense
Licensed Practical Nurse Primary 164W00000X314796-1 (NY)

Licensed Practical Nurse: An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

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About NPI 1629590617

Nicholas Martin Pascullo, LPN's National Provider Identifier is 1629590617, issued on Jul 11, 2017. The primary taxonomy on file is Licensed Practical Nurse (164W00000X), and the practice location is in Lake Ronkonkoma, NY. The record was last updated on Jul 11, 2017.