Individual
BRENDA LYNN JANOTHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
994 W JERICHO TPKE, SUITE 201, SMITHTOWN, NY 11787-3235
(631) 864-4499
Mailing address
3392 LUFBERRY AVE, WANTAGH, NY 11793-3006
(516) 781-6512
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F302705-1
NY
Other
Enumeration date
10/21/2006
Last updated
07/08/2007
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