Healthcare Provider Details
I. General information
NPI: 1477800332
Provider Name (Legal Business Name): VERONICA KLIPACH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/10/2012
Last Update Date: 02/02/2026
Certification Date: 02/02/2026
Deactivation Date: 05/23/2019
Reactivation Date: 11/14/2025
III. Provider practice location address
99 MADISON AVE
NEW YORK NY
10016-7419
US
IV. Provider business mailing address
99 MADISON AVE
NEW YORK NY
10016-7419
US
V. Phone/Fax
- Phone: 347-809-1517
- Fax:
- Phone: 347-809-1517
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | F358644-01 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: