Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | F348061 | NY |
NPI | 1073289039 |
---|---|
Provider Name | Natallia Oksum |
First Address | Bay Shore, NY 11706-4519 |
Second Address | Ridgewood, NY 11385-3261 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2021 |
Last Update Date | 19/08/2021 |