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NPI 1831070317ActiveIndividual· Nurse Practitioner, Adult Health· Forest Hills, NY
Nurse Practitioner, Adult Health in Forest Hills, New York, trained at State University of New York at Stony Brook, School of Medicine (class of 2025). Enrolled in Medicare as practitioner - nurse practitioner.
Overview
| NPI | 1831070317 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | No |
| NPI issued | Sep 10, 2025 |
| Last updated in NPPES | Sep 10, 2025 |
| Certified by provider | Sep 10, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Adult Health Primary | 363LA2200X | F312359-01 | NY |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Nurse Practitioner (NY) |
|---|
Education and affiliations
| Medical school | State University of New York at Stony Brook, School of Medicine |
|---|---|
| Graduation year | 2025 |
| Medicare specialty | Nurse Practitioner |
Medical group
- North Shore-Lij Medical PCStaten Island, NY · 6,440 clinicians
Hospital affiliation
- Long Island Jewish Medical CenterNew Hyde Park, NY
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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