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General NPI Number Information
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NPI Number | 1083589741
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Entity Type | Organization
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Legal Business Name | PLACENCIA FAMILY HEALTH NURSE PRACTITIONER PLLC
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Dates
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Enumeration Date | 10/10/2025
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Last Update Date | 10/10/2025
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Provider Practice Location Address
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Address Line | 240 W 37TH ST FL 5
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City | NEW YORK
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State | NY
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Zip | 10018-5787
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Country | US
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Telephone | 347-674-3635
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Fax |
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Provider Business Mailing Address
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Address Line | 300 WINSTON DR APT 906
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City | CLIFFSIDE PARK
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State | NJ
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Zip | 07010-3215
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Country | US
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Telephone | 347-674-3635
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MITZY PLACENCIA
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Credential | NP
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Telephone | 347-419-5377
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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 |
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License Number State |
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