# HOMEGROWN ESSENTIAL PEDIATRICS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Homegrown Essential Wellness Pediatrics & Family., Homegrown Essential Wellness Pediatrics & Family
- **Organization subpart:** No

## Provider details

- **NPI number:** 1700636164
- **Authorized official:** HEATHER ANN RIDDLE DNP (DNP)
- **Authorized official phone:** (631) 248-2700

## Contact information

- **Practice address:** 267 E MAIN ST BLDG C, SMITHTOWN, NY 11787-2847
- **Practice address phone:** (631) 248-2700
- **Practice address fax:** (866) 456-0906
- **Mailing address:** 267 E MAIN ST BLDG C, SMITHTOWN, NY 11787-2847
- **Mailing address phone:** (631) 248-2700
- **Mailing address fax:** (866) 456-0906

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP2300X | Primary Care Nurse Practitioner | — | NULL | Yes |
| 363LP2300X | Primary Care Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 03/26/2024
- **Last updated:** 08/06/2026