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General NPI Number Information
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NPI Number | 1346620671
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Entity Type | Organization
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Legal Business Name | CARE ONE HOUSE CALLS NP IN FAMILY HEALTH PLLC
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Dates
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Enumeration Date | 06/02/2015
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Last Update Date | 06/02/2015
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Provider Practice Location Address
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Address Line | 79 VELIE RD
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City | LAGRANGEVILLE
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State | NY
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Zip | 12540-5512
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Country | US
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Telephone | 845-590-4624
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Fax | 845-849-3059
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Provider Business Mailing Address
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Address Line | PO BOX 45
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City | LAGRANGEVILLE
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State | NY
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Zip | 12540-0045
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Country | US
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Telephone | 845-590-4624
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Fax | 845-849-3059
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Authorized Official
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Title or Position | CEO
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Name | DANIELLE CULLEN
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Credential | FNP
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Telephone | 845-590-4624
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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 | 339085
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License Number State | NY
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