Sparkle Care Family Health NP PLLC
Clinic/Center in Central Islip, NY. Organization (NPI-2).
NPI number1831892462
StatusActive
Last updated in NPPESMar 23, 2023
Details
- NPI
- 1831892462
- Entity type
- Organization (NPI-2)
- Legal business name
- Sparkle Care Family Health NP PLLC
- Organization subpart
- No
- Enumeration date
- Mar 23, 2023
- Certification date
- Mar 23, 2023
- Last updated
- Mar 23, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261Q00000X | Clinic/Center | – | – | Yes |
Practice location
25 Nicoll AveCentral Islip, NY 11722-3136
Phone 631-605-4089
Mailing address
25 Nicoll AveCentral Islip, NY 11722-3136
Phone 631-605-4089
Authorized official
Takeisha Judkins
Director
6316054089
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