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Organization
SEA WAVE NP ADULT HEALTH PC
Active
Organization
SEA WAVE NP ADULT HEALTH PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEBRA BLAIR (BUSINESS MANAGER)
(347) 693-5790
Entity
Organization
Contact information
Practice address
10 E 39TH ST RM 914, NEW YORK, NY 10016-0111
(347) 389-2008
(877) 632-5925
Mailing address
1164 E 45TH ST, BROOKLYN, NY 11234-1430
(347) 693-5790
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
—
NULL
363LA2200X
Adult Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
03/04/2020
Last updated
03/04/2020
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