Healthcare Provider Details

I. General information

NPI: 1578789723
Provider Name (Legal Business Name): FRUMESS NURSE PRACTITIONER FAMILY HEALTH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43 MAIN STREET
LIVINGSTON MANOR NY
12758
US

IV. Provider business mailing address

10401 N MERIDIAN ST STE 310
INDIANAPOLIS IN
46290-1151
US

V. Phone/Fax

Practice location:
  • Phone: 845-439-8371
  • Fax:
Mailing address:
  • Phone: 317-428-4379
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: NAOMI C. FRUMESS
Title or Position: PRINCIPAL OFFICER
Credential: FNP
Phone: 845-439-8371