Prombanthoa, Supranee

Prombanthoa, Supranee is an individual health care provider with primary practice located at 2201 Hempstead Tpke , East Meadow NY 11554-1859. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Prombanthoa, Supranee can be contacted via phone (516) 572-6501.

Contact Information

Primary practice address
2201 Hempstead Tpke East Meadow NY 11554-1859
Phone: (516) 572-6501
Fax: (516) 572-5609
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 012965 New York

Profile Details

NPI number 1942442223
LBN Legal business name Prombanthoa, Supranee
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 1st, 2009
Last updated Apr 1st, 2009 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1942442223 NPPES
New York Other 012965 NYS LICENSE NUMBER

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