Individual provider · Type 1 NPI
Ruby Ezra, A-GNP
Adult Health Nurse Practitioner · Port Jefferson Station, NY
NPI number
1699088898
Active
Practice location
163 Stuyvesant Dr
Port Jefferson Station, NY 11776-4251
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Registered Nurse | 163W00000X | 569398-1 (NY) |
| Adult Health Nurse Practitioner Primary | 363LA2200X | F308975-1 (NY) |
Adult Health Nurse Practitioner: Definition to come...
Another provider at this address
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About NPI 1699088898
Ruby Ezra, A-GNP's National Provider Identifier is 1699088898, issued on Jul 16, 2010. The primary taxonomy on file is Adult Health Nurse Practitioner (363LA2200X), and the practice location is in Port Jefferson Station, NY. The record was last updated on Jul 2, 2021.