Healthcare Provider Details

I. General information

NPI: 1316838311
Provider Name (Legal Business Name): NURSE PRACTITIONER FAMILY HEALTH & ACUPUNCTURE WELLNESS SVCS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2025
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1995 STATE ROUTE 17M SUITE #2
GOSHEN NY
10924
US

IV. Provider business mailing address

1995 STATE ROUTE 17M SUITE #2
GOSHEN NY
10924
US

V. Phone/Fax

Practice location:
  • Phone: 845-315-7017
  • Fax:
Mailing address:
  • Phone: 845-315-7017
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MRS. UCHENNA E EGWUONWU
Title or Position: NP
Credential: DAOM, FNP, PSYCH NP
Phone: 845-315-7017