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General NPI Number Information
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NPI Number | 1437786977
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Entity Type | Organization
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Legal Business Name | MF FAMILY HEALTH NP PC
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Dates
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Enumeration Date | 03/25/2020
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Last Update Date | 06/07/2022
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Provider Practice Location Address
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Address Line | 2076 HYLAN BLVD STE I
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City | STATEN ISLAND
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State | NY
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Zip | 10306-3427
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Country | US
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Telephone | 718-979-4865
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Fax | 718-979-1842
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Provider Business Mailing Address
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Address Line | 2627 HYLAN BLVD # D2
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City | STATEN ISLAND
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State | NY
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Zip | 10306-4344
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Country | US
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Telephone | 718-285-4440
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Fax | 718-285-4459
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Authorized Official
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Title or Position | OWNER
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Name | MARINA FEST
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Credential |
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Telephone | 718-285-4440
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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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