Healthcare Provider Details

I. General information

NPI: 1205571890
Provider Name (Legal Business Name): JOANNE VAZ NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2022
Last Update Date: 07/23/2024
Certification Date: 07/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

424 E 34TH ST
NEW YORK NY
10016-4901
US

IV. Provider business mailing address

424 E 34TH ST
NEW YORK NY
10016-4901
US

V. Phone/Fax

Practice location:
  • Phone: 516-395-9035
  • Fax:
Mailing address:
  • Phone: 212-263-3790
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number737276
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number405191
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: