Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | F431143-1 | NY |
NPI | 1013428465 |
---|---|
Provider Name | Jennifer Winik |
First Address | Dix Hills, NY 11746-6760 |
Second Address | New York, NY 10075-1850 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2017 |
Last Update Date | 12/10/2017 |