Organization
THEODORA C RAFT NP, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THEODORA C RAFT NP (NP)
(631) 617-2416
Entity
Organization
Contact information
Practice address
290 MAIN ST, EAST SETAUKET, NY 11733-2871
(631) 751-0441
Mailing address
7 CREST CT, MIDDLE ISLAND, NY 11953-2135
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
01/19/2022
Last updated
01/19/2022
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