Individual
FEDLENE LAURISTON-JANVIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHNP
Contact information
Practice address
180 SUNRISE HWY, WEST ISLIP, NY 11795-2012
(631) 893-0150
Mailing address
105 40TH ST, LINDENHURST, NY 11757-2703
(516) 967-1662
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
421674
NY
Other
Enumeration date
11/08/2023
Last updated
11/08/2023
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