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General NPI Number Information
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NPI Number | 1518357375
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Entity Type | Organization
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Legal Business Name | HALSEY FAMILY HEALTH NURSE PRACTITIONER SERVICES OF NEW YORK, PC
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Dates
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Enumeration Date | 02/02/2015
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Last Update Date | 02/02/2015
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Provider Practice Location Address
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Address Line | 13423 229TH ST PVT
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City | LAURELTON
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State | NY
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Zip | 11413-2516
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Country | US
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Telephone | 917-376-3772
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Fax |
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Provider Business Mailing Address
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Address Line | 1086 BROADWAY SUITE 3-5
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City | BROOKLYN
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State | NY
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Zip | 11221-3376
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Country | US
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Telephone | 718-602-2086
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Fax | 718-602-2087
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Authorized Official
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Title or Position | DIRECTOR/PRIMARY CARE PROVIDER
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Name | MRS. KERAN SEVENISE HILL
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Credential | FNP
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Telephone | 718-602-2086
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 333879
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License Number State | NY
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