Healthcare Provider Details

I. General information

NPI: 1205765260
Provider Name (Legal Business Name): PIONEER HEALTH CARE NURSE PRACTITIONER IN FAMILY HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2026
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 SAINT JOHNS AVE
YONKERS NY
10704-2902
US

IV. Provider business mailing address

60 SAINT JOHNS AVE
YONKERS NY
10704-2902
US

V. Phone/Fax

Practice location:
  • Phone: 917-201-8545
  • Fax:
Mailing address:
  • Phone: 917-201-8545
  • 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: PATRICE NICOLE FRASER
Title or Position: FAMILY NURSE PRACTITIONER
Credential: DNP, FNP
Phone: 917-201-8545