ETHY CANON NPI 1558139543

NPI Information

  • NPI: 1558139543
  • Provider Name: ETHY CANON
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • Address: 302 W 148TH ST APT 3A
    NEW YORK, NY
    ZIP 10039
  • Phone: (646) 714-5511

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NPI Details

Ethy Canon is a family nurse practitioner in New York, NY. Ethy Canon NPI is 1558139543. 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:

302 W 148TH ST APT 3A
NEW YORK, NY
ZIP 10039-927
Phone: (646) 714-5511

The enumeration date for this NPI number is 12/19/2023 and was last updated on 12/19/2023.

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
1363LF0000XNurse PractitionerFamily423223NEW YORKYes

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: 11/21/2025

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