Organization
SPARKLE CARE FAMILY HEALTH NP PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAKEISHA JUDKINS NP (DIRECTOR)
(631) 605-4089
Entity
Organization
Contact information
Practice address
25 NICOLL AVE, CENTRAL ISLIP, NY 11722-3136
(631) 605-4089
Mailing address
25 NICOLL AVE, CENTRAL ISLIP, NY 11722-3136
(631) 605-4089
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
03/23/2023
Last updated
03/23/2023
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