Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | 309236-01 | NY |
Y | 363LA2200X | Nurse Practitioner - Adult Health | F309236-01 | NY |
NPI | 1003466780 |
---|---|
Provider Name | Mrs. Heather Marie Caligiuri |
First Address | Smithtown, NY 11787-3448 |
Second Address | Stony Brook, NY 11794-3448 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/09/2019 |
Last Update Date | 30/03/2021 |