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NPI Code Detail

MEDICARE: MS. PHELAN ANTONIA CLANCY A.N.P

MEDICARE:  MS. PHELAN ANTONIA CLANCY  A.N.P
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse6573601NY
2363LA2200XAdult Health Nurse Practitioner306844-1NY

General Provider Information

NPI Number : 1598006660
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. PHELAN ANTONIA CLANCY A.N.P
Provider Business Mailing Address
First Line : 145 W MONTAUK HWY
Second Line :
City : HAMPTON BAYS
State : NY
Zip : 11946-4012
Country : US
Telephone Number : 718-220-0439
Fax Number : 718-933-2914
Provider Business Practice Location Address
First Line : 2336 GRAND CONCOURSE
Second Line :
City : BRONX
State : NY
Zip : 10458-6903
Country : US
Telephone Number : 718-220-0439
Fax Number : 718-933-2914
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/13/2013
Last Update Date : 10/30/2019

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Directions to “ MS. PHELAN ANTONIA CLANCY A.N.P” Practice Location

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