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1265067466
MANJU BIJU SAM
STONY BROOK, NY
NPI
1265067466
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LA2200X Nurse Practitioner, Adult Health
(Licence: NY F309300-01)
Enumeration Date
2020-03-08
Last Update Date
2021-11-23
Business Address
Mrs. MANJU BIJU SAM
101 NICOLLS RD
STONY BROOK, NY 11794-1923
Phone number: 631-632-6868
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Mailing Address
Mrs. MANJU BIJU SAM
4 BERWYN DR
LAKE RONKONKOMA, NY 11779-1923
Phone number: 631-525-1801
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