Basic Information
Provider Information
NPI: 1417421124
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TURNEY
FirstName: HEATHER
MiddleName:  
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NameSuffix:  
Credential:  
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Mailing Information
Address1: 31 SANDS POINT RD
Address2:  
City: PORT WASHINGTON
State: NY
PostalCode: 110501625
CountryCode: US
TelephoneNumber: 9175621116
FaxNumber:  
Practice Location
Address1: 100 PORT WASHINGTON BLVD
Address2:  
City: ROSLYN
State: NY
PostalCode: 115761347
CountryCode: US
TelephoneNumber: 5165626000
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/15/2019
LastUpdateDate: 01/15/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
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AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363A00000X  Y Physician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 

No ID Information.


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