Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | F350324-1 | NY |
N | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | F350324-1 | NY |
NPI | 1093000234 |
---|---|
Provider Name | Mrs. Kristin Ferrara |
First Address | Mineola, NY 11501-3728 |
Second Address | Stony Brook, NY 11794 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2011 |
Last Update Date | 19/06/2018 |