Healthcare Provider Details

I. General information

NPI: 1114774825
Provider Name (Legal Business Name): COMMITTED2CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2024
Last Update Date: 05/01/2024
Certification Date: 05/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 E TILDEN PL
HOPEWELL JUNCTION NY
12533-7391
US

IV. Provider business mailing address

418 BROADWAY # 8444
ALBANY NY
12207-2922
US

V. Phone/Fax

Practice location:
  • Phone: 845-813-0816
  • Fax:
Mailing address:
  • Phone: 845-813-0816
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DR. JOY FEVRIER
Title or Position: NURSE PRACTITIONER
Credential: FNP-C
Phone: 845-813-0816