Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Theresa Jeanne Nicosia, RNMSFNP

Individual provider Family Nurse Practitioner · NPI 1710077821

Theresa Jeanne Nicosia, RNMSFNP is a Nurse Practitioner in Lake Grove, New York. Graduated from State University of New York at Stony Brook, School of Medicine in 2003, 23 years ago. Practices with North Shore-Lij Medical PC, a 6,350-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
23
Trained at
State University of New York at Stony Brook, School of Medicine
Licensed in
NY
In the registry since
2006
Specialties on file
2
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Practice location Address checks out

6 Park View Ln
Lake Grove, NY 11755-1854
Phone: (631) 467-8229
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence F334231-1 (NY)
Primary Care Nurse Practitioner Taxonomy 363LP2300X · Licence F334231 (NY)

Record details

NPI number1710077821
Entity typeIndividual (Type 1)
GenderFemale
Credentials RNMSFNP
Sole proprietorNo
NPI enumeratedOctober 13, 2006
Last updated in NPPESMay 10, 2016

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolSTATE UNIVERSITY OF NEW YORK AT STONY BROOK, SCHOOL OF MEDICINE
Graduated 2003 (23 years in practice)
Group practice North Shore-Lij Medical Pc — 6350 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Lake Grove