Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 308363 | NY |
NPI | 1023537255 |
---|---|
Provider Name | Uma Narayana |
First Address | Port Jefferson Station, NY 11776-1228 |
Second Address | Port Jefferson Station, NY 11776-1228 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/09/2017 |
Last Update Date | 23/04/2019 |