Healthcare Provider Details

I. General information

NPI: 1841121480
Provider Name (Legal Business Name): MIAO FU RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2026
Last Update Date: 05/25/2026
Certification Date: 05/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16710 CROCHERON AVE APT 5K
FLUSHING NY
11358-2166
US

IV. Provider business mailing address

16710 CROCHERON AVE APT 5K
FLUSHING NY
11358-2166
US

V. Phone/Fax

Practice location:
  • Phone: 518-261-2888
  • Fax:
Mailing address:
  • Phone: 518-261-2888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberN26819
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: