Individual
ANA PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10 MEDICAL PLZ STE 208, GLEN COVE, NY 11542-2101
(516) 674-1647
Mailing address
54 CENTRAL PARK RD, PLAINVIEW, NY 11803-2012
(646) 306-0081
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
686204
NY
363LF0000X
Family Nurse Practitioner
Primary
350166
NY
Other
Enumeration date
06/03/2022
Last updated
08/15/2022
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