Healthcare Provider Details

I. General information

NPI: 1861537672
Provider Name (Legal Business Name): ESMIE MORRIS-TAYLOR GNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ESMIE MORRIS-TAYLOR GNP

II. Dates (important events)

Enumeration Date: 02/20/2007
Last Update Date: 08/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1072 GRAND CONCOURSE
BRONX NY
10456-3901
US

IV. Provider business mailing address

25901 148 AVENUE ROSEDALE 1072 GRANDCOURSE
BRONX NY
10465
US

V. Phone/Fax

Practice location:
  • Phone: 718-681-4000
  • Fax: 718-681-5165
Mailing address:
  • Phone: 718-681-4000
  • Fax: 718-681-5165

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberF340581
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: