Individual
LISA PEREIRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGNP-C
Contact information
Practice address
70 N COUNTRY RD STE 102, PORT JEFFERSON, NY 11777-2161
(631) 938-6999
(631) 403-2749
Mailing address
70 N COUNTRY RD STE 102, PORT JEFFERSON, NY 11777-2161
(631) 938-6999
(631) 403-2749
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F310362
NY
Other
Enumeration date
10/08/2021
Last updated
02/06/2024
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