Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | F306000-1 | NY |
NPI | 1023555133 |
---|---|
Provider Name | Andrea Schmitz |
First Address | Halesite, NY 11743-2210 |
Second Address | Huntington, NY 11743-2787 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2017 |
Last Update Date | 26/01/2017 |