| NPI | 1649369067 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TANYA ADAMS Owner 631-941-4480 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 2278671) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 4893961) |
| 363LF0000X Nurse Practitioner, Family (Licence: NY F334091) | |
| 363LF0000X Nurse Practitioner, Family (Licence: NY F3040001) | |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2020-08-22 |