Individual
TRACY DOURDOUNAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
320 CARLETON AVE, CENTRAL ISLIP, NY 11722-4506
(631) 234-7807
Mailing address
10 HOUGHTON BLVD, STONY BROOK, NY 11790-1511
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
305164
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
405098
NY
Other
Enumeration date
03/31/2010
Last updated
12/23/2023
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