Healthcare Provider Details

I. General information

NPI: 1194516161
Provider Name (Legal Business Name): PAMELA HOSSEIN AGPCNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2025
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

380 MERRICK AVE
EAST MEADOW NY
11554-2701
US

IV. Provider business mailing address

2 RUTH RD
PLAINVIEW NY
11803-1918
US

V. Phone/Fax

Practice location:
  • Phone: 516-505-0097
  • Fax:
Mailing address:
  • Phone: 917-225-8642
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number311872
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: