EBENEZER PREMKUMAR THANGAVELU

LINDENHURST, NY
NPI1780673228
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363LA2200X Nurse Practitioner, Adult Health
(Licence: NY  F 302708-1)
Enumeration Date2005-10-18
Last Update Date2016-05-18
Business Address
Mr. EBENEZER PREMKUMAR THANGAVELU NP
143 S 9TH ST
LINDENHURST, NY 11757-4523
Phone number: 516-983-5754
Mailing Address
Mr. EBENEZER PREMKUMAR THANGAVELU NP
143 SOUTH 9TH STREET
LINDENHURST, NY 11757
Phone number: 631-957-1859
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