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General NPI Number Information
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NPI Number | 1134327422
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Entity Type | Organization
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Legal Business Name | FAMILY HEALTH & MEDICAL AESTHETIC CENTER INC
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Dates
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Enumeration Date | 07/06/2007
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Last Update Date | 08/22/2011
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Provider Practice Location Address
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Address Line | 421 S FRANKLIN ST
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City | HEMPSTEAD
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State | NY
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Zip | 11550-7336
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Country | US
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Telephone | 718-496-9203
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Fax |
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Provider Business Mailing Address
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Address Line | 7607 ROOSEVELT AVE
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City | JACKSON HEIGHTS
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State | NY
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Zip | 11372-6635
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Country | US
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Telephone | 718-496-9203
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Fax |
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Authorized Official
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Title or Position | FNP
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Name | MS. LISA DEL POZO
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Credential | FNP
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Telephone | 718-496-9203
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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 | F333926
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License Number State | NY
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