Individual
JOAN L NATHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
A.N.P.
Contact information
Practice address
120 N COUNTRY RD, PORT JEFFERSON, NY 11777-2604
(631) 928-4586
Mailing address
2200 RACE AVE, MEDFORD, NY 11763-1818
(631) 730-6024
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
302124
NY
Other
Enumeration date
03/23/2007
Last updated
07/08/2007
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