Individual
MRS. CORNELLA RENEE BREWINGTON-JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
50 WHEELER RD, CENTRAL ISLIP, NY 11722-2154
(631) 348-5139
Mailing address
50 WHEELER RD, CENTRAL ISLIP, NY 11722-2154
(631) 348-5139
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
358039-1
NY
363LP0200X
Pediatric Nurse Practitioner
Primary
F381362-1
NY
Other
Enumeration date
09/29/2010
Last updated
01/30/2020
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