Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | F4001711 | NY |
NPI | 1013920933 |
---|---|
Provider Name | Mrs. Patricia B Meyer |
First Address | Stony Brook, NY 11790 |
Second Address | Stony Brook, NY 11790 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2006 |
Last Update Date | 04/01/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
S98255 | (02) |