Healthcare Provider Details

I. General information

NPI: 1417875428
Provider Name (Legal Business Name): KATIA LOMELI AGPCNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 GIDNEY AVE
NEWBURGH NY
12550-2823
US

IV. Provider business mailing address

611 GIDNEY AVE
NEWBURGH NY
12550-2823
US

V. Phone/Fax

Practice location:
  • Phone: 845-528-7322
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberF312870
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: