Individual
MRS. BLAIR M WHITLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
300 COMMUNITY DR, MANHASSET, NY 11030-3816
(516) 562-0100
Mailing address
20 ERLAND RD, STONY BROOK, NY 11790-1114
(631) 806-1358
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F346085-01
NY
Other
Enumeration date
08/31/2020
Last updated
08/31/2020
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