Provider Demographics
NPI:1528480258
Name:SUND, URSZULA ELIZABETH (ANP)
Entity type:Individual
Prefix:
First Name:URSZULA
Middle Name:ELIZABETH
Last Name:SUND
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 NICOLLS RD
Mailing Address - Street 2:HOSPITAL T- 18030, HEALTH SCIENCE CENTER
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11794-8183
Mailing Address - Country:US
Mailing Address - Phone:631-444-3577
Mailing Address - Fax:
Practice Address - Street 1:101 NICOLLS RD
Practice Address - Street 2:HOSPITAL T- 18030, HEALTH SCIENCE CENTER
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794-8183
Practice Address - Country:US
Practice Address - Phone:631-444-3577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-15
Last Update Date:2014-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3066601363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health