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Individual

MRS. TERESA SARA MORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PNP-PC

Contact information

Practice address
1362 E FORKS RD, BAY SHORE, NY 11706-5039
(631) 664-3106
Mailing address
1362 E FORKS RD, BAY SHORE, NY 11706-5039
(631) 664-3106

Taxonomy

Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
604439
NY
363LP0200X
Pediatric Nurse Practitioner
Primary
383600
NY

Other

Enumeration date
12/08/2023
Last updated
12/08/2023
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