Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | F303097-1 | NY |
NPI | 1003016502 |
---|---|
Provider Name | Coleen Ryan-Frank |
First Address | Seaford, NY 11783-1300 |
Second Address | Seaford, NY 11783-1300 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/07/2007 |
Last Update Date | 24/09/2008 |