Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | F400946-1 | NY |
NPI | 1003094723 |
---|---|
Provider Name | Mrs. Eva Macdowall |
First Address | Stony Brook, NY 11790-0989 |
Second Address | Greenport, NY 11944-1222 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/02/2008 |
Last Update Date | 26/07/2019 |