Healthcare Provider Details

I. General information

NPI: 1447196209
Provider Name (Legal Business Name): QUALITY CARE FAMILY HEALTH NP PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2026
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2375 RICHMOND RD STE 4
STATEN ISLAND NY
10306-2352
US

IV. Provider business mailing address

2375 RICHMOND RD STE 4
STATEN ISLAND NY
10306-2352
US

V. Phone/Fax

Practice location:
  • Phone: 646-226-5276
  • Fax:
Mailing address:
  • Phone: 646-226-5276
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: CHRYSTAL C FAN
Title or Position: NP
Credential: FNP
Phone: 567-377-6100