Individual
LIZA ESCOBAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
101 NICOLLS RD, STONY BROOK, NY 11794-0001
(631) 689-8333
Mailing address
2238 WALNUT AVE, RONKONKOMA, NY 11779-6627
(631) 655-8887
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
308037
NY
Other
Enumeration date
10/18/2021
Last updated
10/18/2021
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