Healthcare Provider Details

I. General information

NPI: 1033559091
Provider Name (Legal Business Name): NURSE PRACTITIONER IN FAMILY HEALTH, HEALTH CARE SOLUTIONS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/04/2013
Last Update Date: 08/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22909 87TH AVE
QUEENS VILLAGE NY
11427-2654
US

IV. Provider business mailing address

22909 87TH AVE
QUEENS VILLAGE NY
11427-2654
US

V. Phone/Fax

Practice location:
  • Phone: 917-853-1069
  • Fax:
Mailing address:
  • Phone: 917-853-1069
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF334400
License Number StateNY

VIII. Authorized Official

Name: MICHELE D AVENT
Title or Position: OWNER
Credential: NP
Phone: 917-853-1069