Healthcare Provider Details

I. General information

NPI: 1033066030
Provider Name (Legal Business Name): DENEIL ANGELLA HARDY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/11/2026
Last Update Date: 03/11/2026
Certification Date: 03/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22121 JAMAICA AVE
QUEENS VILLAGE NY
11428-2015
US

IV. Provider business mailing address

22146 114TH AVE
CAMBRIA HEIGHTS NY
11411-1217
US

V. Phone/Fax

Practice location:
  • Phone: 718-468-6923
  • Fax:
Mailing address:
  • Phone: 347-432-6626
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: