Healthcare Provider Details

I. General information

NPI: 1811433998
Provider Name (Legal Business Name): NFP HEALTH GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2017
Last Update Date: 07/12/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13640 39TH AVE SUITE 403
FLUSHING NY
11354-5536
US

IV. Provider business mailing address

13640 39TH AVE SUITE 403
FLUSHING NY
11354
US

V. Phone/Fax

Practice location:
  • Phone: 917-627-4618
  • Fax: 718-767-2191
Mailing address:
  • Phone: 718-353-8460
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number204187
License Number StateNY

VIII. Authorized Official

Name: DR. NANCY FAN-PAUL
Title or Position: PHYSICIAN/OWNER
Credential: M.D.
Phone: 718-353-8460