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General NPI Number Information
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NPI Number | 1114800620
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Entity Type | Organization
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Legal Business Name | LI NP IN FAMILY HEALTH AND ADULT HEALTH PLLC
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Dates
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Enumeration Date | 07/30/2025
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Last Update Date | 07/30/2025
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Provider Practice Location Address
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Address Line | 28 S MAIN ST
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City | SAYVILLE
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State | NY
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Zip | 11782-3104
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Country | US
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Telephone | 516-250-3044
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Fax | 631-938-9451
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Provider Business Mailing Address
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Address Line | 28 S MAIN ST
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City | SAYVILLE
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State | NY
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Zip | 11782-3104
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Country | US
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Telephone | 516-250-3044
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Fax | 631-938-9451
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | MICAELA VIRGILIO
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Credential | NP
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Telephone | 516-250-3044
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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