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General NPI Number Information
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NPI Number | 1154095966
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Entity Type | Individual
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Provider Name | AMINA ROSALIE EMANUEL NP
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Gender | Female
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Dates
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Enumeration Date | 08/04/2021
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Last Update Date | 08/04/2021
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Provider Practice Location Address
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Address Line | 104 VERMILYEA AVE
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City | NEW YORK
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State | NY
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Zip | 10034-3209
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Country | US
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Telephone | 212-544-8854
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Fax |
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Provider Business Mailing Address
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Address Line | 1169 E NEW YORK AVE APT 3A
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City | BROOKLYN
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State | NY
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Zip | 11212-3882
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Country | US
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Telephone | 917-207-1384
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | F347378-01
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License Number State | NY
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