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Organization
SOR FAMILY HEALTH NURSE PRACTITIONER
Active
Organization
SOR FAMILY HEALTH NURSE PRACTITIONER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAKIRAYE ROOKWOOD (OWNER)
(718) 360-3214
Entity
Organization
Contact information
Practice address
165 N VILLAGE AVE STE 9, ROCKVILLE CENTRE, NY 11570-3701
(516) 682-2350
(949) 695-2245
Mailing address
71 E SEAMAN AVE, FREEPORT, NY 11520-1643
(516) 682-2350
(949) 695-2245
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
01/03/2024
Last updated
01/17/2024
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