| Nicole Squillacioti I, PA-C | |
| 
					207 Glen Cove Ave, Sea Cliff, NY 11579-1455  | |
| (516) 676-1742 | |
| Not Available | 
| Full Name | Nicole Squillacioti I | 
|---|---|
| Gender | Female | 
| Speciality | Physician Assistant | 
| Location | 207 Glen Cove Ave, Sea Cliff, New York | 
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1932877701 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 363A00000X | Physician Assistant | (New York) | Secondary | 
| 363A00000X | Physician Assistant | 027702 (New York) | Primary | 
| Mailing Address | Practice Location Address | 
|---|---|
| Nicole Squillacioti I, PA-C 24 Honved St, Hicksville, NY 11801-2243 Ph: (516) 303-6771  | Nicole Squillacioti I, PA-C 207 Glen Cove Ave, Sea Cliff, NY 11579-1455 Ph: (516) 676-1742  | 
Ms. Krysten Anne Raymond, RPA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 207 Glen Cove Ave, Sea Cliff, NY 11579 Phone: 516-676-1742 Fax: 516-676-9662  | |
Mr. Christian Anthony Lorentzen, R-PAC Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 207 Glen Cove Ave, Sea Cliff, NY 11579 Phone: 631-265-5858  | |
Melinda Rose Malloy, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 207 Glen Cove Ave, Sea Cliff, NY 11579 Phone: 516-676-1742  | |
Lacey Fater, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 207 Glen Cove Ave, Sea Cliff, NY 11579 Phone: 516-676-1742  | |
Mr. Richard Kushay, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 207 Glen Cove Ave, Sea Cliff, NY 11579 Phone: 516-676-1742 Fax: 516-676-9662  |