Individual
KACEY JOHANNAH PRYZBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
444 N SEA RD, SOUTHAMPTON, NY 11968-2057
(631) 283-4843
Mailing address
444 N SEA RD, SOUTHAMPTON, NY 11968-2057
(631) 283-4843
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
382897
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
382897
LICENSE NUMBER
NY
Enumeration date
08/06/2018
Last updated
08/06/2018
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