Healthcare Provider Details

I. General information

NPI: 1457658098
Provider Name (Legal Business Name): MAUREEN STOKES-MCCARTHY FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/17/2011
Last Update Date: 02/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

217-O3 ROCKAWAY POINT BLVD
BREEZY POINT NY
11697-0000
US

IV. Provider business mailing address

217-O3 ROCKAWAY POINT BLVD
BREEZY POINT NY
11697-0000
US

V. Phone/Fax

Practice location:
  • Phone: 718-634-8540
  • Fax:
Mailing address:
  • Phone: 718-634-8540
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF336452-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: