Individual
JILL NIELSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
450 WAVERLY AVE, SUITE 4, PATCHOGUE, NY 11772-1555
(631) 475-5705
Mailing address
450 WAVERLY AVE, SUITE 4, PATCHOGUE, NY 11772-1555
(631) 475-5705
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
F390035-1
NY
Other
Enumeration date
01/03/2007
Last updated
07/08/2007
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