Individual
MARY WERTHEIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
STONY BROOK MEDICINE EM, 100 NICOLLS ROAD, HSC, LEVEL 4, ROOM 080, STONY BROOK, NY 11794-8350
(631) 444-2478
Mailing address
29 SETALCOTT PL, SETAUKET, NY 11733-1323
(631) 624-6857
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F307318-1
NY
Other
Enumeration date
10/12/2015
Last updated
08/01/2016
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