Radiance Wellness NP in Family Health PLLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

RADIANCE WELLNESS NP IN FAMILY HEALTH PLLC

Practice address

674 Dogwood Ave
Franklin Square, NY 11010-3247

Phone

(631) 796-1888

Fax

(929) 290-0328

NPI assigned

Oct 7, 2024

Last updated

Oct 7, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Sergina Jean, NPNPI 1073936647

Title

Family Nurse Practitioner

Phone

(631) 796-1888

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Sergina Jean, FNP

  • Family Nurse Practitioner
  • Franklin Square, NY
  • NPI 1073936647

  Clinic/Center

  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1728259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728259200000",
    "number": "1841019049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "674 DOGWOOD AVE",
            "city": "FRANKLIN SQUARE",
            "state": "NY",
            "postal_code": "110103247",
            "telephone_number": "631-796-1888",
            "fax_number": "929-290-0328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "674 DOGWOOD AVE",
            "city": "FRANKLIN SQUARE",
            "state": "NY",
            "postal_code": "110103247",
            "telephone_number": "631-796-1888",
            "fax_number": "929-290-0328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADIANCE WELLNESS NP IN FAMILY HEALTH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-07",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-06",
        "status": "A",
        "authorized_official_last_name": "JEAN",
        "authorized_official_first_name": "SERGINA",
        "authorized_official_title_or_position": "FAMILY NURSE PRACTITIONER",
        "authorized_official_telephone_number": "631-796-1888",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04405827",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Professional Orthopedic and Sports Physical Therapy, PC
• Psychologist on Wheels PC (Child and Family Psychology)
• Mitsu Purohit, PT
• Richard F Raad, MA
• Judith Rackmil, LCSW, CASAC, APRN,BC
• Sebin Raj, RN
• Jerry Raju
• Kristin Ramirez
• Joanna Ramos
• Jakara Rance-Fisher

• Family Nurse Practitioner in Franklin Square, NY
• Providers in Franklin Square, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.