Individual
MS. JOELLEN ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4 PHYLLIS DR, STE H, PATCHOGUE, NY 11772-2900
(631) 447-7560
(631) 774-7561
Mailing address
1400 DEWEY AVE, NORTH BELLMORE, NY 11710-2131
(516) 783-1947
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F400410
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
164773
VALUE OPTIONS GOV'T
NY
01
—
7482405
VALUE OPTIONS
NY
Enumeration date
03/15/2007
Last updated
07/08/2007
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