Provider Demographics
NPI:1053669614
Name:NURSE PRACTITIONERS IN ADULT HEALTH SERVICES, PLLC
Entity Type:Organization
Organization Name:NURSE PRACTITIONERS IN ADULT HEALTH SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:COLLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEEHAN
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:516-361-2038
Mailing Address - Street 1:184 OLD COUNTRY ROAD
Mailing Address - Street 2:FIRST FLOOR
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501
Mailing Address - Country:US
Mailing Address - Phone:516-361-2038
Mailing Address - Fax:516-673-9553
Practice Address - Street 1:184 OLD COUNTRY ROAD
Practice Address - Street 2:FIRST FLOOR
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501
Practice Address - Country:US
Practice Address - Phone:516-361-2038
Practice Address - Fax:516-673-9553
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-29
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY305624363LA2200X
NY305646363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty