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Organization
TNLJ NP LLC
Active
Organization
TNLJ NP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAKEISHA JUDKINS (OWNER)
(718) 517-1660
Entity
Organization
Contact information
Practice address
25 NICOLL AVE, CENTRAL ISLIP, NY 11722-3136
(718) 517-1660
Mailing address
25 NICOLL AVE, CENTRAL ISLIP, NY 11722-3136
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
12/09/2021
Last updated
12/09/2021
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