Individual
MRS. PREMA UDAYAKUMAR ETHIRAJULU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1 HEALTHY WAY, E-3, OCEANSIDE, NY 11572-1551
(516) 632-3640
(516) 336-2958
Mailing address
1 HEALTHY WAY, E-3, OCEANSIDE, NY 11572-1551
(516) 632-4862
(516) 336-2956
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
F 306701
NY
Other
Enumeration date
03/21/2014
Last updated
04/28/2015
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