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Individual

MRS. TJADA S GARVIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
18 NORWOOD PL, WYANDANCH, NY 11798-1029
(631) 805-6956
Mailing address
18 NORWOOD PL, WYANDANCH, NY 11798-1029
(631) 805-6956

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
578008
NY
363L00000X
Nurse Practitioner
Primary
F311885
NY

Other

Enumeration date
03/31/2008
Last updated
08/21/2024
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