Individual
JAREA SMALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
805 NORTHERN BLVD, GREAT NECK, NY 11021-5342
(516) 773-7737
Mailing address
58 BENBURB ST, AMITYVILLE, NY 11701-1454
(631) 565-9784
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F311368
NY
Other
Enumeration date
08/15/2023
Last updated
08/15/2023
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