Individual
CECILIA VANISKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
4 ROOSEVELT AVE, PORT JEFFERSON STATION, NY 11776-3363
(631) 331-0500
(631) 331-1644
Mailing address
900 MERCHANTS CONCOURSE STE 216, WESTBURY, NY 11590-5114
(516) 226-8373
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
360059
NY
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
360059
NY
Other
Enumeration date
04/16/2007
Last updated
12/03/2019
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