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Organization
RADIANCE WELLNESS NP IN FAMILY HEALTH PLLC
Active
Organization
RADIANCE WELLNESS NP IN FAMILY HEALTH PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SERGINA JEAN NP (FAMILY NURSE PRACTITIONER)
(631) 796-1888
Entity
Organization
Contact information
Practice address
674 DOGWOOD AVE, FRANKLIN SQUARE, NY 11010-3247
(631) 796-1888
(929) 290-0328
Mailing address
674 DOGWOOD AVE, FRANKLIN SQUARE, NY 11010-3247
(631) 796-1888
(929) 290-0328
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04405827
—
NY
Enumeration date
10/07/2024
Last updated
10/07/2024
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