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General NPI Number Information
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NPI Number | 1649858770
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Entity Type | Organization
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Legal Business Name | NU HORIZONS LLC
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Dates
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Enumeration Date | 03/30/2021
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Last Update Date | 03/30/2021
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Provider Practice Location Address
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Address Line | 2171 JERICHO TPKE STE 338
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City | COMMACK
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State | NY
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Zip | 11725-2914
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Country | US
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Telephone | 631-252-3311
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Fax |
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Provider Business Mailing Address
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Address Line | 2171 JERICHO TPKE STE 338
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City | COMMACK
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State | NY
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Zip | 11725-2914
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Country | US
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Telephone | 631-252-3311
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MS. TRACY PAQUETTE
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Credential |
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Telephone | 631-252-3311
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2472R0900X
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Taxonomy Name | Renal Dialysis Technician
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License Number |
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License Number State |
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