Healthcare Provider Details

I. General information

NPI: 1114652252
Provider Name (Legal Business Name): HANA SICHEL NURSE PRACTITIONER IN FAMILY HEALTH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2022
Last Update Date: 07/21/2022
Certification Date: 07/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3530 WAYNE AVE
BRONX NY
10467-1511
US

IV. Provider business mailing address

28 FLANNERY AVE
LAKEWOOD NJ
08701-4750
US

V. Phone/Fax

Practice location:
  • Phone: 732-267-8747
  • Fax:
Mailing address:
  • Phone: 732-267-8747
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: CHAIM FRANCIS
Title or Position: MANAGER
Credential:
Phone: 732-267-8747