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General NPI Number Information
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NPI Number | 1063921922
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Entity Type | Organization
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Legal Business Name | FEAFEA MOORE PEAL NURSE PRACTITIONER IN FAMILY HEALTH PLLC
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Dates
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Enumeration Date | 09/22/2017
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Last Update Date | 10/14/2025
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Provider Practice Location Address
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Address Line | 153 4TH AVE
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City | BROOKLYN
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State | NY
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Zip | 11217-3108
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Country | US
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Telephone | 718-529-1648
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Fax |
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Provider Business Mailing Address
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Address Line | 14507 130TH AVE
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City | JAMAICA
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State | NY
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Zip | 11436-2234
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Country | US
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Telephone | 718-529-1648
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Fax |
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Authorized Official
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Title or Position | FAMILY NURSE PRACTITIONER
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Name | MRS. FEAFEA MOORE PEAL
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Credential | FNP
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Telephone | 347-858-2497
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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 | 337511
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License Number State | NY
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