| NPI | 1679161012 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA WAUGH Nurse Practitioner 718-362-1411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care |
| Enumeration Date | 2020-12-31 |
| Last Update Date | 2025-06-04 |