Healthcare Provider Details

I. General information

NPI: 1033368204
Provider Name (Legal Business Name): NANCY ELLEN IANKOWITZ DNP, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/12/2008
Last Update Date: 03/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 GREAT BEAR RD
HOLMES NY
12531-5326
US

IV. Provider business mailing address

24 GREAT BEAR RD
HOLMES NY
12531-5326
US

V. Phone/Fax

Practice location:
  • Phone: 917-716-6802
  • Fax:
Mailing address:
  • Phone: 917-716-6802
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF330293-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: