Sundberg, Michelina
Sundberg, Michelina is an individual health care provider with primary practice located at 951 Roanoke Ave , Riverhead NY 11901-2724. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Sundberg, Michelina can be contacted via phone (631) 369-5005.Contact Information
Primary practice address
951 Roanoke Ave
Riverhead NY 11901-2724
Phone: (631) 369-5005
Fax: (631) 369-4994
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | 008222 | New York |
Profile Details
| NPI number | 1669462370 |
|---|---|
| LBN Legal business name | Sundberg, Michelina |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 24th, 2005 |
| Last updated | Apr 2nd, 2021 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1669462370 | NPPES |
| New York | MEDICAID | 02519753 |
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