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General NPI Number Information
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NPI Number | 1154078335
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Entity Type | Organization
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Legal Business Name | THE VINE NP FAMILY HEALTH PLLC
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Dates
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Enumeration Date | 03/07/2022
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Last Update Date | 09/15/2025
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Provider Practice Location Address
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Address Line | 230 HILTON AVE STE 105
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City | HEMPSTEAD
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State | NY
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Zip | 11550-8116
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Country | US
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Telephone | 718-954-3553
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Fax | 877-762-6647
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Provider Business Mailing Address
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Address Line | 11944 218TH ST
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City | CAMBRIA HEIGHTS
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State | NY
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Zip | 11411-1911
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Country | US
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Telephone | 718-954-3553
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Fax | 877-762-6647
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Authorized Official
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Title or Position | NP
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Name | KELLY HILAIRE
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Credential |
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Telephone | 718-233-9122
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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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