Individual
MISS TANYA M WATSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1440 PORT WASHINGTON BLVD, PORT WASHINGTON, NY 11050-2412
(516) 849-7854
Mailing address
25320 147TH RD, ROSEDALE, NY 11422-2826
(917) 515-3686
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
F308751-1
NY
Other
Enumeration date
04/22/2020
Last updated
04/22/2020
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