Individual
ALICIA MYRIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
192 LONGFELLOW DR, MASTIC BEACH, NY 11951-2224
(631) 816-0021
Mailing address
110 BEAVER DAM RD, BROOKHAVEN, NY 11719-9719
(631) 286-8100
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
603197-1
NY
363LA2200X
Adult Health Nurse Practitioner
Primary
F308824
NY
Other
Enumeration date
04/28/2016
Last updated
07/02/2021
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