Healthcare Provider Details

I. General information

NPI: 1265580625
Provider Name (Legal Business Name): CATHERINE NOZDROVICKY NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

419-31 ATLANTIC AVE APT 1A
EAST ROCKAWAY NY
11518-3038
US

IV. Provider business mailing address

623 STEWART AVE
GARDEN CITY NY
11530-4771
US

V. Phone/Fax

Practice location:
  • Phone: 516-356-9569
  • Fax: 516-593-1046
Mailing address:
  • Phone: 516-356-9569
  • Fax: 516-593-1046

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberF430221
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: