Healthcare Provider Details

I. General information

NPI: 1740083039
Provider Name (Legal Business Name): LHOVELY JOY FONTIMAYOR RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2025
Last Update Date: 03/31/2025
Certification Date: 03/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2811 QUEENS PLZ N FL 5
LONG ISLAND CITY NY
11101-4172
US

IV. Provider business mailing address

2811 QUEENS PLZ N
LONG ISLAND CITY NY
11101-4172
US

V. Phone/Fax

Practice location:
  • Phone: 718-391-8300
  • Fax:
Mailing address:
  • Phone: 718-391-8300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Registered Nurse
License Number889934
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: