Healthcare Provider Details

I. General information

NPI: 1730943432
Provider Name (Legal Business Name): MA BARBARA V HOBILLA FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/13/2024
Last Update Date: 08/12/2024
Certification Date: 08/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4422 3RD AVE
BRONX NY
10457-2545
US

IV. Provider business mailing address

14445 CHARTER RD APT 10GA
BRIARWOOD NY
11435-6417
US

V. Phone/Fax

Practice location:
  • Phone: 718-960-9000
  • Fax:
Mailing address:
  • Phone: 646-327-8691
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number2022003870
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: