Healthcare Provider Details

I. General information

NPI: 1366542003
Provider Name (Legal Business Name): PAULETTE FRISCIA CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

506 6TH ST KP4
BROOKLYN NY
11215-3609
US

IV. Provider business mailing address

506 6TH ST KP4
BROOKLYN NY
11215-3609
US

V. Phone/Fax

Practice location:
  • Phone: 718-780-5065
  • Fax: 718-780-5085
Mailing address:
  • Phone: 718-780-5065
  • Fax: 718-780-5085

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number42-420051
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: