Healthcare Provider Details

I. General information

NPI: 1093174591
Provider Name (Legal Business Name): DEBBIE MARIE KOVARY RN BSN.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/12/2016
Last Update Date: 02/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 WEST HILLS RD. WAL WHITMAN HIGH SCHOOL
HUNTINGTON STA. NY
11746
US

IV. Provider business mailing address

60 WESTON ST.
HUNTINGTON STA. NY
11746
US

V. Phone/Fax

Practice location:
  • Phone: 631-812-3810
  • Fax: 631-812-3819
Mailing address:
  • Phone: 631-812-3000
  • Fax: 631-812-3165

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number292688-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: