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General NPI Number Information
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NPI Number | 1609178698
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Entity Type | Individual
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Provider Name | BETSY TOMY PAUL NP
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Gender | Female
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Dates
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Enumeration Date | 11/23/2010
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Last Update Date | 11/23/2010
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Provider Practice Location Address
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Address Line | 450 LAKEVILLE ROAD CENTER FOR ADVANCED MEDICINE AMBULATORY SURGERY CENTER
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City | LAKE SUCCESS
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State | NY
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Zip | 11042-1034
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Country | US
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Telephone | 516-734-8070
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Fax |
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Provider Business Mailing Address
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Address Line | 8125 265TH ST FLORAL PARK
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City | GLEN OAKS
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State | NY
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Zip | 11004-1534
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Country | US
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Telephone | 718-343-0979
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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 | F305160-1
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License Number State | NY
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