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General NPI Number Information
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NPI Number | 1245750918
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Entity Type | Organization
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Legal Business Name | LONG ISLAND NURSE PRACTITIONERS
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Dates
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Enumeration Date | 06/23/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 97 RONNI DR
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City | EAST MEADOW
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State | NY
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Zip | 11554-1330
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Country | US
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Telephone | 516-543-8630
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Fax |
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Provider Business Mailing Address
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Address Line | 97 RONNI DR
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City | EAST MEADOW
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State | NY
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Zip | 11554-1330
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Country | US
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Telephone | 516-543-8630
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | PATRICIA ANN SULLIVAN
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Credential | NO
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Telephone | 516-459-2497
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number |
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License Number State |
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