Healthcare Provider Details

I. General information

NPI: 1902667199
Provider Name (Legal Business Name): SABRINA PALMER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/16/2024
Last Update Date: 09/09/2024
Certification Date: 09/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

857 S OYSTER BAY RD
BETHPAGE NY
11714-1030
US

IV. Provider business mailing address

208 ROANOKE AVE
RIVERHEAD NY
11901-2706
US

V. Phone/Fax

Practice location:
  • Phone: 516-622-8888
  • Fax:
Mailing address:
  • Phone: 631-284-2565
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberF405509
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: