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Individual

NANCY KOH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP-C

Contact information

Practice address
LAUTERBUR DRIVE MART BUILDING, STONY BROOK, NY 11794
(631) 432-4773
Mailing address
LAUTERBUR DRIVE - MART BUILDING, STONY BROOK, NY 11794
(631) 432-4773

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
580838-1
NY
363LA2200X
Adult Health Nurse Practitioner
Primary
F306106-1
NY

Other

Enumeration date
01/10/2013
Last updated
05/12/2022
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