MEDICARE: ELIZABETH HEALY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WS0200X	School Registered Nurse	446470-01	NY

General Provider Information

NPI Number	:	1841042173
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH HEALY

Provider Business Mailing Address
First Line	:	70 BRENTWOOD RD
Second Line	:
City	:	BAY SHORE
State	:	NY
Zip	:	11706-6947
Country	:	US
Telephone Number	:	631-968-1290
Fax Number	:	631-969-5188

Provider Business Practice Location Address
First Line	:	70 BRENTWOOD RD
Second Line	:
City	:	BAY SHORE
State	:	NY
Zip	:	11706-6947
Country	:	US
Telephone Number	:	631-968-1290
Fax Number	:	631-969-5188

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/02/2024
Last Update Date	:	04/02/2024

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Directions to “ ELIZABETH HEALY ” Practice Location

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