Healthcare Provider Details

I. General information

NPI: 1033579560
Provider Name (Legal Business Name): DAVID LEE HYLTON FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/25/2016
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13740 LAURELTON PKWY
ROSEDALE NY
11422-1708
US

IV. Provider business mailing address

13740 LAURELTON PKWY
ROSEDALE NY
11422-1708
US

V. Phone/Fax

Practice location:
  • Phone: 917-277-7601
  • Fax: 917-970-9762
Mailing address:
  • Phone: 718-208-9704
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number346800
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number711721
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: