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General NPI Number Information
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NPI Number | 1558232108
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Entity Type | Organization
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Legal Business Name | ANNADALE NP IN FAMILY HEALTH P.C.
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Dates
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Enumeration Date | 09/16/2025
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Last Update Date | 11/06/2025
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Provider Practice Location Address
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Address Line | 3974 AMBOY RD STE 302
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City | STATEN ISLAND
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State | NY
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Zip | 10308-2414
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Country | US
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Telephone | 718-967-1071
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Fax |
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Provider Business Mailing Address
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Address Line | 3974 AMBOY RD STE 302
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City | STATEN ISLAND
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State | NY
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Zip | 10308-2414
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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 | FNP
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Name | IRENA HOVHANNISYAN
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Credential | FNP
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Telephone | 646-406-9286
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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 |
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License Number State |
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