Healthcare Provider Details

I. General information

NPI: 1831870401
Provider Name (Legal Business Name): CARMEN YIP FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2023
Last Update Date: 07/27/2023
Certification Date: 07/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

506 6TH ST
BROOKLYN NY
11215-3609
US

IV. Provider business mailing address

1650 78TH ST
BROOKLYN NY
11214-1012
US

V. Phone/Fax

Practice location:
  • Phone: 917-915-5308
  • Fax:
Mailing address:
  • Phone: 917-915-5308
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number351391
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: