FAMILY HEALTH NURSE PRACTITIONER HOME VISITS PC NPI 1083942544

NPI Information

NPI: 1083942544
Provider Name: FAMILY HEALTH NURSE PRACTITIONER HOME VISITS PC
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Organization

Specialization: Family

Address:
9605 220TH ST
QUEENS VILLAGE, NY
ZIP 11429
Phone: (646) 201-8985
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FAMILY HEALTH NURSE PRACTITIONER HOME VISITS PC is a family nurse practitioner in Queens Village, NY. FAMILY HEALTH NURSE PRACTITIONER HOME VISITS PC NPI is 1083942544. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

9605 220TH ST
QUEENS VILLAGE, NY
ZIP 11429-347
Phone: (646) 201-8985

The provider's authorized official is Alexander Kotov .
The authorized official title is Medical Director and has the following contact phone number (646) 201-8985.

The enumeration date for this NPI number is 11/21/2009 and was last updated on 1/12/2016.

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
1	363LF0000X	Nurse Practitioner	Family	F333427-1	NEW YORK	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	G100065207	OTHER	NEW YORK	MEDICARE PTAN
2	02177773	MEDICAID	NEW YORK

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: 4/28/2024

NPI Synchronization or Removal

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