Healthcare Provider Details

I. General information

NPI: 1760954754
Provider Name (Legal Business Name): KARESA A MCPHOY DNP, FNP-BC, A-GNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KARESA A MCPHOY DNP, FNP-BC, A-GNP

II. Dates (important events)

Enumeration Date: 01/02/2019
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3380 RESERVOIR OVAL E
BRONX NY
10467-3100
US

IV. Provider business mailing address

3380 RESERVOIR OVAL E
BRONX NY
10467-3100
US

V. Phone/Fax

Practice location:
  • Phone: 516-474-1132
  • Fax:
Mailing address:
  • Phone: 187-696-4126
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number343734
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number308019
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: