Organization · Type 2 NPI

Homegrown Essential Pediatrics

Primary Care Nurse Practitioner · Smithtown, NY

NPI number 1700636164 Active

Practice location

267 E Main St Bldg C
Smithtown, NY 11787-2847

Fax (866) 456-0906

Specialties and licenses

Taxonomy	Code	License
Primary Care Nurse Practitioner Primary	363LP2300X	None listed

Primary Care Nurse Practitioner: Definition to come...

6 other providers at this address

NPI record

NPI: 1700636164
Entity type: Organization (Type 2)
Issued: Mar 26, 2024
Last updated: Aug 6, 2026
Status: Active

Other names

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Homegrown Essential Wellness Pediatrics & Family · doing business as
Homegrown Essential Wellness Pediatrics & Family · doing business as

Authorized official

Heather Ann Riddle, DNP
DNP
(631) 248-2700

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About NPI 1700636164

Homegrown Essential Pediatrics's National Provider Identifier is 1700636164, issued on Mar 26, 2024. The primary taxonomy on file is Primary Care Nurse Practitioner (363LP2300X), and the practice location is in Smithtown, NY. The record was last updated on Aug 6, 2026.