Healthcare Provider Details

I. General information

NPI: 1033804323
Provider Name (Legal Business Name): STEFANIE FLOWER CPNP-PC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2023
Last Update Date: 04/11/2023
Certification Date: 04/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

134 MINEOLA BLVD
MINEOLA NY
11501-3959
US

IV. Provider business mailing address

28 RUSHMORE ST
HUNTINGTON STATION NY
11746-4428
US

V. Phone/Fax

Practice location:
  • Phone: 516-294-9363
  • Fax:
Mailing address:
  • Phone: 516-297-6483
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberF383461
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: