Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | 38-382270 | NY |
NPI | 1023382660 |
---|---|
Provider Name | Mrs. Joanne M Camarda |
First Address | Stony Brook, NY 11790-0989 |
Second Address | Stony Brook, NY 11794-2911 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/02/2012 |
Last Update Date | 24/02/2020 |