| Doctor Name: | NANCY C DEACON |
| NPI Number: | 1134475189 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | N.P. |
| License Number: | 401496 |
| Business Practice Address: | 150 Broadhollow Road Suite 310 Melville, NY - 11747 |
| Business Phone Number: | 6316367050 |
| Business Fax Number: | 6314232111 |
| Mailing Address: | 80 Salem Ridge Dr, HUNTINGTON |
| State: | NY |
| Postal Code: | 11743 |
| Phone Number: | 6316367050 |
| Fax Number: | 6315491097 |
| NPI Enumeration Date: | 07/27/2012 |
| NPI Last Update Date: | 06/25/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | 401496 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |