MEDICARE: MS. PHYLLIS PINARD NPP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	F400988-1	NY

General Provider Information

NPI Number	:	1427139401
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. PHYLLIS PINARD NPP

Provider Business Mailing Address
First Line	:	368 VETERANS MEMORIAL HWY
Second Line	:
City	:	COMMACK
State	:	NY
Zip	:	11725-4322
Country	:	US
Telephone Number	:	631-606-6022
Fax Number	:

Provider Business Practice Location Address
First Line	:	368 VETERANS MEMORIAL HWY
Second Line	:
City	:	COMMACK
State	:	NY
Zip	:	11725-4322
Country	:	US
Telephone Number	:	631-606-6022
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/18/2006
Last Update Date	:	04/02/2024

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