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General NPI Number Information
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NPI Number | 1689596835
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Entity Type | Organization
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Legal Business Name | NORTH BAY NURSE PRACTITIONER IN ADULT HEALTH PLLC
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Dates
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Enumeration Date | 07/29/2026
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Last Update Date | 07/29/2026
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Provider Practice Location Address
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Address Line | 123 MCKINLEY DR
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City | MASTIC BEACH
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State | NY
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Zip | 11951-7213
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Country | US
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Telephone | 631-428-3851
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Fax |
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Provider Business Mailing Address
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Address Line | 123 MCKINLEY DR
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City | MASTIC BEACH
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State | NY
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Zip | 11951-7213
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Country | US
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Telephone | 631-428-3851
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JASON LAYUG
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Credential | NURSE PRACTITIONER
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Telephone | 631-428-3851
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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