Healthcare Provider Details

I. General information

NPI: 1124371984
Provider Name (Legal Business Name): HOPE O. ENYENIHI MS, RN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/17/2012
Last Update Date: 10/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 BIRCHGROVE DR
CENTRAL ISLIP NY
11722-1904
US

IV. Provider business mailing address

17 BIRCHGROVE DR
CENTRAL ISLIP NY
11722-1904
US

V. Phone/Fax

Practice location:
  • Phone: 516-543-8217
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number337332
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: