Healthcare Provider Details

I. General information

NPI: 1558225169
Provider Name (Legal Business Name): KR FAMILY HEALTH NP PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2025
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 NEPTUNE RD STE P23
POUGHKEEPSIE NY
12601-5500
US

IV. Provider business mailing address

828 FEDERAL RD STE B
BROOKFIELD CT
06804-1847
US

V. Phone/Fax

Practice location:
  • Phone: 800-611-0185
  • Fax: 800-930-5241
Mailing address:
  • Phone: 800-611-0185
  • Fax: 800-930-5241

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: MARCO NAGUIB
Title or Position: CEO
Credential:
Phone: 800-611-0185