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General NPI Number Information
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NPI Number | 1164923785
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Entity Type | Organization
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Legal Business Name | NP IN FAMILY HEALTH ON DEMAND 247 PLLC
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Dates
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Enumeration Date | 02/28/2018
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Last Update Date | 02/28/2018
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Provider Practice Location Address
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Address Line | 1119 OCEAN PKWY APT F5
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City | BROOKLYN
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State | NY
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Zip | 11230-4017
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Country | US
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Telephone | 347-760-8197
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Fax |
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Provider Business Mailing Address
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Address Line | 1901 DORCHESTER ROAD PH
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City | BROOKLYN
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State | NY
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Zip | 11226-6768
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING SPECIALIST
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Name | MRS. GALINA HOOLIN
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Credential |
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Telephone | 216-215-5420
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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