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Contact Information

LORA L MAMUYAC, AGPCNP
18 1ST AVE
HOLTSVILLE, NY11742-4208
 Phone: 631-902-8439
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Adult Health

363LA2200X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for LORA L MAMUYAC · (Female)

NPI # 1275053142
Status Active
Credentials AGPCNP
Entity Individual
Enumeration date 06/22/2017
Last updated 06/22/2017 - About 9 years ago
Sole proprietor 1 Yes
Identifiers
  • NY License # F307956-1
Hospital affiliation(s)
  • BROOKHAVEN MEMORIAL HOSPITAL MEDICAL CENTER - (Acute Care)
    101 HOSPITAL ROAD
    PATCHOGUE, NY 11772
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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