Provider Demographics
NPI:1316312911
Name:BISWAS, ANITA NEOGI (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:ANITA
Middle Name:NEOGI
Last Name:BISWAS
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:421 DEER PARK AVE
Mailing Address - Street 2:
Mailing Address - City:BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11702-2313
Mailing Address - Country:US
Mailing Address - Phone:631-941-1000
Mailing Address - Fax:631-941-2747
Practice Address - Street 1:421 DEER PARK AVE
Practice Address - Street 2:
Practice Address - City:BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11702-2313
Practice Address - Country:US
Practice Address - Phone:631-941-1000
Practice Address - Fax:631-941-2747
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-08
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4704286155363LA2200X, 363LP2300X
NY307575363LA2200X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care