Healthcare Provider Details

I. General information

NPI: 1215976642
Provider Name (Legal Business Name): FARNA BAPTISTE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2006
Last Update Date: 10/18/2021
Certification Date: 10/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

632 BROADWAY PH
NEW YORK NY
10012-2614
US

IV. Provider business mailing address

64 BLEECKER ST # 151
NEW YORK NY
10012-2410
US

V. Phone/Fax

Practice location:
  • Phone: 347-933-6246
  • Fax: 855-318-8277
Mailing address:
  • Phone: 347-933-6246
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number333503
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: