NPI 1053438952

Joan L Nathan, ANP

Practitioner Adult Health Nurse Practitioner Port Jefferson, NY

Practice location

Address: 120 N Country Rd, Port Jefferson, NY 11777-2604
Phone: (631) 928-4586
Mailing address: 2200 Race Ave, Medford, NY 11763-1818

Registered specialties

Adult Health Nurse Practitioner Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363LA2200X Licence 302124 (NY)

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Registry record

NPI: 1053438952
Entity type: Individual
Sex (as registered): Female
NPI issued: 23 Mar 2007
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.