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Individual

STEPHANIE GEORGE PORTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
270 PARK AVE, HUNTINGTON, NY 11743-2787
(631) 351-2035
Mailing address
270 PARK AVE, HUNTINGTON, NY 11743-2787
(631) 351-2035

Taxonomy

Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
640467
NY
363LA2200X
Adult Health Nurse Practitioner
640467
NY
363LG0600X
Gerontology Nurse Practitioner
640467
NY

Other

Enumeration date
08/11/2017
Last updated
07/21/2022
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