Individual
MRS. MIRIAM CORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, CPNP-PC
Contact information
Practice address
500 COMMACK RD UNIT 150F, COMMACK, NY 11725-5009
(631) 499-4114
Mailing address
25 STANWICH RD, SMITHTOWN, NY 11787-2356
(631) 312-0938
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
589995-01
NY
363LP0200X
Pediatric Nurse Practitioner
Primary
F383586-01
NY
Other
Enumeration date
06/15/2023
Last updated
06/15/2023
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