Healthcare Provider Details

I. General information

NPI: 1003159286
Provider Name (Legal Business Name): CELIA ENGELSON FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/05/2013
Last Update Date: 03/26/2021
Certification Date: 03/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 E 41ST ST
NEW YORK NY
10017-6739
US

IV. Provider business mailing address

222 E 41ST ST
NEW YORK NY
10017-6739
US

V. Phone/Fax

Practice location:
  • Phone: 212-263-7744
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number337816
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: