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General NPI Number Information
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NPI Number | 1003200965
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Entity Type | Individual
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Provider Name | ASHLEY RAE NOBOA MSN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 03/27/2015
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Last Update Date | 07/26/2021
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Provider Practice Location Address
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Address Line | 3415 BAINBRIDGE AVE
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City | BRONX
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State | NY
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Zip | 10467-2403
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Country | US
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Telephone | 718-920-7200
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Fax | 718-547-2929
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Provider Business Mailing Address
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Address Line | 3355 BAINBRIDGE AVE
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City | BRONX
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State | NY
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Zip | 10467-2801
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Country | US
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Telephone | 347-703-8799
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Fax | 718-547-2929
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP127819
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 340189
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License Number State | NY
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