Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | F430083-1 | NY |
NPI | 1013458801 |
---|---|
Provider Name | Mary P Furlong |
First Address | New Rochelle, NY 10801-1830 |
Second Address | New Rochelle, NY 10801-1830 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2017 |
Last Update Date | 14/03/2017 |