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Organization
HEALTH-BASED PRIMARY CARE
Active
Organization
HEALTH-BASED PRIMARY CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHEREDA LAWRENCE (NURSE PRACTITIONER)
(917) 326-1701
Entity
Organization
Contact information
Practice address
11 GLADYSZ WAY, PORT JEFFERSON, NY 11777-2263
(917) 326-1701
Mailing address
11 GLADYSZ WAY, PORT JEFFERSON, NY 11777-2263
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
05/27/2024
Last updated
11/12/2024
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