Organization
RAIO NURSE PRACTITIONER IN ADULT HEALTHCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTY M RAIO NP (NURSE PRACTITIONER)
(631) 404-2399
Entity
Organization
Contact information
Practice address
35 HICKORY AVE, FARMINGVILLE, NY 11738-1713
(631) 404-2399
Mailing address
PO BOX 538, PORT JEFFERSON STATION, NY 11776-0538
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
565087
STATE LICENSE
NY
Enumeration date
08/30/2021
Last updated
08/30/2021
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