Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | F350002 | NY |
NPI | 1083771968 |
---|---|
Provider Name | Patricia E Brill |
First Address | East Islip, NY 11730-0272 |
Second Address | Port Jefferson, NY 11777-1928 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/01/2007 |
Last Update Date | 08/07/2007 |