Individual provider · Type 1 NPI
Ebenezer Premkumar Thangavelu, NP
Adult Health Nurse Practitioner · Lindenhurst, NY
NPI number
1780673228
Active
Practice location
143 S 9th St
Lindenhurst, NY 11757-4523
Mailing address
143 South 9th Street
Lindenhurst, NY 11757
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Adult Health Nurse Practitioner Primary | 363LA2200X | F 302708-1 (NY) |
Adult Health Nurse Practitioner: Definition to come...
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About NPI 1780673228
Ebenezer Premkumar Thangavelu, NP's National Provider Identifier is 1780673228, issued on Oct 18, 2005. The primary taxonomy on file is Adult Health Nurse Practitioner (363LA2200X), and the practice location is in Lindenhurst, NY. The record was last updated on May 18, 2016.