Healthcare Provider Details

I. General information

NPI: 1760628259
Provider Name (Legal Business Name): FLORENCE LEILA HUEY FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/05/2009
Last Update Date: 01/05/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

460 W 41ST ST COVENANT HOUSE NEW YORK
NEW YORK NY
10036-6801
US

IV. Provider business mailing address

296 SHERMAN AVE FL1
JERSEY CITY NJ
07307-1933
US

V. Phone/Fax

Practice location:
  • Phone: 212-613-0300
  • Fax: 212-268-2832
Mailing address:
  • Phone: 201-424-6458
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF334856-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number27NJ00132800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: