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Individual

MS. NOLYN C NYATANGA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
260 W SUNRISE HWY, VALLEY STREAM, NY 11581-1011
(718) 732-4049
(631) 751-0506
Mailing address
1500 ROUTE 112 STE 101, PORT JEFFERSON STATION, NY 11776-8054
(631) 751-3000
(631) 751-0506

Taxonomy

Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
2015010241
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03906787
NY
Enumeration date
05/01/2009
Last updated
02/16/2022
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