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General NPI Number Information
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NPI Number | 1134429376
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Entity Type | Organization
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Legal Business Name | ANN E. PERRY-BLIZZARD NP-PSYCHIATRY, P.C.
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Dates
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Enumeration Date | 10/21/2010
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Last Update Date | 10/21/2010
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Provider Practice Location Address
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Address Line | 140 BELLE MEADE ROAD, SUITE A
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City | SETAUKET
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State | NY
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Zip | 11733
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Country | US
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Telephone | 631-689-5390
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Fax | 631-689-5395
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Provider Business Mailing Address
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Address Line | 5 FAIRWIND CT
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City | OAKDALE
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State | NY
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Zip | 11769
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Country | US
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Telephone | 631-689-5390
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Fax | 631-689-5395
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Authorized Official
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Title or Position | NP-PSYCHIATRY
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Name | MRS. ANN E PERRY-BLIZZARD
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Credential | NP-PSYCHIATRY
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Telephone | 631-689-5390
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | F401214-1
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License Number State | NY
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