Provider Demographics
NPI:1467625624
Name:JEREMIAH, KATHLEEN UZZI (ANP)
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:UZZI
Last Name:JEREMIAH
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1486 DEER PARK
Mailing Address - Street 2:UNIT A
Mailing Address - City:NORTH BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11703
Mailing Address - Country:US
Mailing Address - Phone:631-422-3200
Mailing Address - Fax:631-422-6597
Practice Address - Street 1:1486 DEER PARK
Practice Address - Street 2:UNIT A
Practice Address - City:NORTH BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11703
Practice Address - Country:US
Practice Address - Phone:631-422-3200
Practice Address - Fax:631-422-6597
Is Sole Proprietor?:No
Enumeration Date:2008-04-09
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYF302309-1363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health