Healthcare Provider Details

I. General information

NPI: 1871830232
Provider Name (Legal Business Name): DEBORAH F HUFNAGEL R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/04/2013
Last Update Date: 01/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

58 CHURCH DR
MASTIC BEACH NY
11951-2303
US

IV. Provider business mailing address

58 CHURCH DR
MASTIC BEACH NY
11951-2303
US

V. Phone/Fax

Practice location:
  • Phone: 631-772-2151
  • Fax:
Mailing address:
  • Phone: 631-772-2151
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number594399
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: