Healthcare Provider Details

I. General information

NPI: 1265971238
Provider Name (Legal Business Name): NP FAMILY HEALTH VISITS & NP ADULT HEALTH VISITS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2017
Last Update Date: 02/23/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 N PLANK RD SUITE 10
NEWBURGH NY
12550-2111
US

IV. Provider business mailing address

17 N PLANK RD SUITE 10
NEWBURGH NY
12550-2111
US

V. Phone/Fax

Practice location:
  • Phone: 845-800-9305
  • Fax: 844-800-1470
Mailing address:
  • Phone: 845-800-9305
  • Fax: 844-800-1470

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: YVONNE PASQUALICCHIO
Title or Position: ADMINISTRATIVE DIRECTOR
Credential:
Phone: 845-800-9305