Organization
PJS REGISTERED PROFESSIONAL NURSING PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LUIS J EHRMAN ANP-C (NURSE PRACTIONER)
(631) 790-1239
Entity
Organization
Contact information
Practice address
22 MISSISSIPPI AVE, PORT JEFFERSON STATION, NY 11776-3012
(631) 790-1239
Mailing address
22 MISSISSIPPI AVE, PORT JEFFERSON STATION, NY 11776-3012
(631) 790-1239
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
304949
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03075505
—
NY
01
—
1568617645
INDIVDUAL NPI
—
Enumeration date
06/24/2011
Last updated
06/24/2011
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