| Joane Phanord, | |
|
2 Fairfield Cir, Apt 3a, Brentwood, NY 11717-4712 | |
| (631) 357-3408 | |
| Not Available |
| Full Name | Joane Phanord |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Psychiatric/mental Health |
| Location | 2 Fairfield Cir, Brentwood, New York |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750665071 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 163W00000X | Registered Nurse | 647623 (New York) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 3094035 (New York) | Primary |
| Entity Name | Family Service League Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1528093242 PECOS PAC ID: 4284524448 Enrollment ID: O20040319000463 |
| Entity Name | Psychiatric Care Medical Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1952946386 PECOS PAC ID: 0749616241 Enrollment ID: O20200131000768 |
| Mailing Address | Practice Location Address |
|---|---|
| Joane Phanord, 998 Crooked Hill Rd, Brentwood, NY 11717-1019 Ph: (631) 388-4269 | Joane Phanord, 2 Fairfield Cir, Apt 3a, Brentwood, NY 11717-4712 Ph: (631) 357-3408 |
Ms. Maryellen Cucuzzo, NURSE PRACTITIONER Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 600 Suffolk Ave Ste C, Brentwood, NY 11717 Phone: 631-273-3712 Fax: 631-273-3745 | |
Gina Bogdanowicz, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1001 Crooked Hill Rd, Brentwood, NY 11717 Phone: 631-287-8500 | |
Lynda Lyon, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1841 Brentwood Rd, Brentwood, NY 11717 Phone: 631-853-7300 | |
Mrs. Joann Marie Basile, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1841 Brentwood Rd, Brentwood, NY 11717 Phone: 631-853-7300 Fax: 631-853-7301 | |
Jennifer Vasquez, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 36 Fairdale Dr, Brentwood, NY 11717 Phone: 631-860-8548 | |
Theretha Gilbert, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1841 Brentwood Rd, Brentwood, NY 11717 Phone: 631-853-2783 | |
Mrs. Eileen Melendez-rivas, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 737 Commack Rd, Brentwood, NY 11717 Phone: 631-388-7500 |