MRS. MIRIAM LEE PENNISE NP NPI 1790882397

NPI Information

  • NPI: 1790882397
  • Provider Name: MRS. MIRIAM LEE PENNISE, NP
  • Classification: Nurse Practitioner - 363LA2200X
  • Specialization: Adult Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 340 VETERANS HWY STE 12
    COMMACK, NY
    ZIP 11725
  • Phone: (631) 486-8400

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NPI Details

MRS. Miriam Lee Pennise, NP is an adult health nurse practitioner in Commack, NY. MRS. Miriam Lee Pennise, NP NPI is 1790882397. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

340 VETERANS HWY STE 12
COMMACK, NY
ZIP 11725-300
Phone: (631) 486-8400
Fax: (631) 486-8080

The NPI 1790882397 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 9/19/2006 and was last updated on 12/6/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LA2200XNurse PractitionerAdult Health379-297 RNNEW YORKYes
2363LA2200XNurse PractitionerAdult Health301536 NPNEW YORKNo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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