Healthcare Provider Details

I. General information

NPI: 1669709663
Provider Name (Legal Business Name): ALLISON ANDRENO NORFUL ANP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/11/2009
Last Update Date: 10/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 GLEN COVE AVE NORTH COAST INTERNAL MEDICINE
SEA CLIFF NY
11579-1455
US

IV. Provider business mailing address

PO BOX 95000-6625
PHILADELPHIA PA
19195-6625
US

V. Phone/Fax

Practice location:
  • Phone: 516-676-1742
  • Fax: 516-676-9662
Mailing address:
  • Phone: 631-465-6297
  • Fax: 631-465-6524

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberF305150-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: