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General NPI Number Information
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NPI Number | 1255808796
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Entity Type | Individual
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Provider Name | STEPHANIE RAGONE
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Gender | Female
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Dates
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Enumeration Date | 11/01/2018
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Last Update Date | 11/01/2018
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Provider Practice Location Address
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Address Line | 891 NORTHERN BLVD
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City | GREAT NECK
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State | NY
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Zip | 11021-5334
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Country | US
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Telephone | 516-773-6300
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Fax |
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Provider Business Mailing Address
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Address Line | 5837 251ST ST
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City | LITTLE NECK
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State | NY
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Zip | 11362-2103
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Country | US
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Telephone | 516-250-9203
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | F308934-1
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License Number State | NY
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