Individual
MICHELLE SHUBOVICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2 STONEHENGE LN, EAST NORTHPORT, NY 11731-4520
(917) 388-7856
Mailing address
2 STONEHENGE LN, EAST NORTHPORT, NY 11731-4520
(917) 388-7856
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
310308
NY
Other
Enumeration date
10/04/2021
Last updated
10/04/2021
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