Individual
EVA DZIERGOWSKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
363 ROUTE 111, SMITHTOWN, NY 11787-4756
(631) 209-4255
Mailing address
363 ROUTE 111, SMITHTOWN, NY 11787-4756
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
403157
NY
Other
Enumeration date
08/20/2020
Last updated
12/15/2020
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