Provider Demographics
NPI:1437967577
Name:SETAUKET NURSE PRACTITIONER IN FAMILY HEALTH P.C.
Entity type:Organization
Organization Name:SETAUKET NURSE PRACTITIONER IN FAMILY HEALTH P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DOREEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:631-523-7826
Mailing Address - Street 1:336 NICOLLS RD
Mailing Address - Street 2:
Mailing Address - City:DEER PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11729-1806
Mailing Address - Country:US
Mailing Address - Phone:631-523-7826
Mailing Address - Fax:
Practice Address - Street 1:140 N BELLE MEAD RD
Practice Address - Street 2:SUITE A
Practice Address - City:EAST SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733-6400
Practice Address - Country:US
Practice Address - Phone:631-523-7826
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-20
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty