Healthcare Provider Details

I. General information

NPI: 1962898577
Provider Name (Legal Business Name): PRISCILLA YING-NGAI FUNG NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2015
Last Update Date: 04/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1250 BROADWAY 2ND FLOOR
NEW YORK NY
10001-3701
US

IV. Provider business mailing address

1250 BROADWAY 2ND FLOOR
NEW YORK NY
10001-3701
US

V. Phone/Fax

Practice location:
  • Phone: 212-609-6316
  • Fax:
Mailing address:
  • Phone: 212-609-6316
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SA2100X
TaxonomyAcute Care Clinical Nurse Specialist
License NumberF430895-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: