Individual
JEREMAE FAJARDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
101 NICOLLS RD, STONY BROOK, NY 11794-2151
(631) 689-8333
Mailing address
187 OYSTER BAY RD, LOCUST VALLEY, NY 11560-2323
(915) 593-9081
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
432719
NY
Other
Enumeration date
05/22/2024
Last updated
08/13/2024
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