Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LW0102X | Nurse Practitioner - Women's Health | 421185 | NY |
Y | 363LW0102X | Nurse Practitioner - Women's Health | F421185-1 | NY |
NPI | 1013315654 |
---|---|
Provider Name | Sarah Haseney |
First Address | West Islip, NY 11795-3822 |
Second Address | Great Neck, NY 11021-5335 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/12/2014 |
Last Update Date | 17/03/2018 |