Individual
MRS. ELIZEBETH SHIBBU VERGHESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN,MSN,ANP-C
Contact information
Practice address
301 E MAIN ST, BAY SHORE, NY 11706-8408
(631) 968-3000
(631) 968-7495
Mailing address
301 E MAIN ST, BAY SHORE, NY 11706-8408
(631) 968-3000
(631) 968-7495
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F305834
NY
Other
Enumeration date
12/01/2012
Last updated
12/01/2012
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