# STATION CARE NP IN ADULT HEALTH PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1801605761
- **Authorized official:** MUBUSHAR IKRAM RAZA AGNP (OWNER/ AGNP)
- **Authorized official phone:** (631) 961-8775

## Contact information

- **Practice address:** 55 2ND AVE UNIT 2, BRENTWOOD, NY 11717-4665
- **Practice address phone:** (631) 983-3237
- **Practice address fax:** (631) 961-8775
- **Mailing address:** 55 2ND AVE UNIT 2, BRENTWOOD, NY 11717-4665
- **Mailing address phone:** (631) 983-3237
- **Mailing address fax:** (631) 961-8775

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LA2200X | Adult Health Nurse Practitioner | — | NULL | Yes |
| 363LA2200X | Adult Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 01/06/2025
- **Last updated:** 06/29/2026