Individual
JENNY THOMAS CHEMPARATHY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
79 MIDDLEVILLE RD, NORTHPORT, NY 11768-2200
(516) 713-7565
Mailing address
1650 BARD LN, EAST MEADOW, NY 11554-1505
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F308791
NY
Other
Enumeration date
09/30/2018
Last updated
09/30/2018
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