NISHA SUSAN PRINCE-MATTATHIL NURSE PRACTITIONER
NPI 1396362646
Nurse Practitioner - Family in Huntington, NY
Active since July 02, 2020
About Nisha Susan Prince-mattathil Nurse Practitioner NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
NISHA SUSAN PRINCE-MATTATHIL NURSE PRACTITIONER (NPI 1396362646) is an individual family provider in Huntington, New York, licensed in New York (1792786) and active in the NPI registry since July 2020.
NPPES Registry Identity
NPI1396362646
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameNISHA SUSAN PRINCE-MATTATHILCredential: NURSE PRACTITIONER
Location Address789 PARK AVEHuntington, NY 11743-3912
Mailing Address789 Park AveHuntington, NY 11743-3912 · (631) 386-3402
Phone(631) 386-3402
Sole ProprietorNo
Enumeration DateJuly 2, 2020
Last NPPES UpdateAugust 6, 20224 updates tracked since enumeration
NPPES CertifiedAugust 6, 2022
✔ NPI 1396362646 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in NY · 1792786
789 PARK AVE, Huntington, NY 11743
Other Providers at the Same Location NPPES 8
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Clinical Medical Laboratory
789 PARK AVE
HUNTINGTON, NY 11743
HUNTINGTON, NY 11743
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1396362646, enumerated as an "individual" on July 02, 2020.
The provider is located at 789 PARK AVE HUNTINGTON, NY 11743 and the phone number is (631) 386-3402.
Nurse Practitioner with taxonomy code 363LF0000X and a focus in Family.
