Healthcare Provider Details

I. General information

NPI: 1407632508
Provider Name (Legal Business Name): ELEANOR YIP NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/05/2023
Last Update Date: 11/13/2023
Certification Date: 11/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

530 1ST AVE STE 9U
NEW YORK NY
10016-6402
US

IV. Provider business mailing address

530 1ST AVE STE 9U
NEW YORK NY
10016-6402
US

V. Phone/Fax

Practice location:
  • Phone: 212-263-7751
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number864488
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number432850
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: