Healthcare Provider Details

I. General information

NPI: 1831221423
Provider Name (Legal Business Name): CLAIRE WISNER NAGLE NNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/10/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 E 68TH ST GREENBERG PAVILION 6 WEST
NEW YORK NY
10021-4870
US

IV. Provider business mailing address

9902 3RD AVE APT. 5D
BROOKLYN NY
11209-7938
US

V. Phone/Fax

Practice location:
  • Phone: 212-746-0318
  • Fax:
Mailing address:
  • Phone: 718-238-6786
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License NumberF350025-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: