Provider Demographics
NPI:1700050119
Name:PERUGGIA, ANTOINETTE (FNP)
Entity type:Individual
Prefix:MS
First Name:ANTOINETTE
Middle Name:
Last Name:PERUGGIA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1123 BELCAMP GARTH
Mailing Address - Street 2:
Mailing Address - City:BELCAMP
Mailing Address - State:MD
Mailing Address - Zip Code:21017-1452
Mailing Address - Country:US
Mailing Address - Phone:667-454-0530
Mailing Address - Fax:
Practice Address - Street 1:918 HEMPSTEAD TPKE
Practice Address - Street 2:APARTMENT 2
Practice Address - City:FRANKLIN SQUARE
Practice Address - State:NY
Practice Address - Zip Code:11010-3637
Practice Address - Country:US
Practice Address - Phone:516-305-4766
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-16
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY498588-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse