Individual
KATHRYN NILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3600 ROUTE 112, CORAM, NY 11727-4116
(631) 920-8302
Mailing address
1985 MARCUS AVE STE 100, NEW HYDE PARK, NY 11042-2025
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
09/03/2024
Last updated
09/03/2024
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