Individual
DONNA LEE BOEHM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
1320 STONY BROOK RD STE 100, STONY BROOK, NY 11790-2222
(631) 941-2273
(631) 941-2501
Mailing address
45 RESEARCH WAY STE 105, EAST SETAUKET, NY 11733-6401
(631) 638-3240
(631) 350-7143
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F303323-01
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05459889
—
NY
Enumeration date
08/16/2007
Last updated
12/07/2022
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