Healthcare Provider Details

I. General information

NPI: 1821914292
Provider Name (Legal Business Name): BRIANNA ARCHER MCCANN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6403 223RD PL
OAKLAND GARDENS NY
11364-2344
US

IV. Provider business mailing address

6403 223RD PL
OAKLAND GARDENS NY
11364-2344
US

V. Phone/Fax

Practice location:
  • Phone: 631-681-1482
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number737234
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number737234
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: