Healthcare Provider Details

I. General information

NPI: 1649157447
Provider Name (Legal Business Name): ADELENE EGAN PANDEY FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 E 68TH ST
NEW YORK NY
10065-4870
US

IV. Provider business mailing address

126 PROSPECT PL APT 1
BROOKLYN NY
11217-2857
US

V. Phone/Fax

Practice location:
  • Phone: 508-847-6003
  • Fax:
Mailing address:
  • Phone: 508-847-6003
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License Number1111111
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: