Healthcare Provider Details

I. General information

NPI: 1538091772
Provider Name (Legal Business Name): EILEEN FERREIRA FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11208 SPRINGFIELD BLVD
QUEENS VILLAGE NY
11429-2650
US

IV. Provider business mailing address

122 LAUDATEN WAY
WARWICK NY
10990-3856
US

V. Phone/Fax

Practice location:
  • Phone: 718-805-0037
  • Fax:
Mailing address:
  • Phone: 646-764-0057
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF359276
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: