Healthcare Provider Details

I. General information

NPI: 1497482715
Provider Name (Legal Business Name): LADIES OF CASA FAMILY HEALTH & PSYCHIATRIC NP SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2022
Last Update Date: 08/05/2022
Certification Date: 08/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

726 QUINCY ST #4
BROOKLYN NY
11221
US

IV. Provider business mailing address

726 QUINCY ST #4
BROOKLYN NY
11221
US

V. Phone/Fax

Practice location:
  • Phone: 718-271-9505
  • Fax:
Mailing address:
  • Phone: 718-271-9505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: GINA ANN CUNEO-RAMOS
Title or Position: OWNER/PARTNER
Credential: FNP-BC
Phone: 718-877-5323