NPI | 1346937737 |
---|---|
Entity Type | Organization |
Authorized Contact | KENISHA T. WOOD Nurse Practitioner/ Owner 631-219-8520 |
Organization Subpart ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
Enumeration Date | 2023-04-18 |
Last Update Date | 2024-03-04 |