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General NPI Number Information
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NPI Number | 1114668969
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Entity Type | Organization
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Legal Business Name | DAYS NURSE PRACTITIONER IN FAMILY HEALTH P.C.
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Dates
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Enumeration Date | 04/05/2022
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Last Update Date | 06/17/2022
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Provider Practice Location Address
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Address Line | 14210 ROOSEVELT AVE STE P10
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City | FLUSHING
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State | NY
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Zip | 11354-6000
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Country | US
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Telephone | 929-362-2082
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Fax | 929-362-2083
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Provider Business Mailing Address
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Address Line | 15751 19TH AVE
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City | WHITESTONE
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State | NY
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Zip | 11357-3820
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Country | US
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Telephone | 917-881-0690
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Fax | 929-362-2083
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Authorized Official
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Title or Position | FAMILY PHYSICIAN
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Name | SHENGJIE MO
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Credential |
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Telephone | 917-881-0690
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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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 |
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License Number State |
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