Provider Demographics
NPI: | 1780901124 |
---|---|
Name: | YVONNE PINEIRO NP ADULT HEALTH, P.C. |
Entity type: | Organization |
Organization Name: | YVONNE PINEIRO NP ADULT HEALTH, P.C. |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | NURSE PRACTITIONER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | YVONNE |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | PINEIRO |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | NP |
Authorized Official - Phone: | 631-655-3427 |
Mailing Address - Street 1: | 54 FICUS RD |
Mailing Address - Street 2: | |
Mailing Address - City: | ROCKY POINT |
Mailing Address - State: | NY |
Mailing Address - Zip Code: | 11778-9382 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 631-655-3427 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 729 ROANOKE AVE |
Practice Address - Street 2: | SUITE A |
Practice Address - City: | RIVERHEAD |
Practice Address - State: | NY |
Practice Address - Zip Code: | 11901-2729 |
Practice Address - Country: | US |
Practice Address - Phone: | 631-655-3427 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2010-04-26 |
Last Update Date: | 2010-05-07 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NY | F304436-1 | 261QM1000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 261QM1000X | Ambulatory Health Care Facilities | Clinic/Center | Migrant Health |