Individual
DIANA PURTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DNP, FNP, ENP
Contact information
Practice address
101 NICOLLS RD, STONY BROOK, NY 11794-0001
(631) 638-1036
Mailing address
7 SHORT CT, EAST NORTHPORT, NY 11731-4316
(516) 286-4914
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
654806
NY
363LF0000X
Family Nurse Practitioner
Primary
F349756
NY
Other
Enumeration date
10/10/2022
Last updated
10/10/2022
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