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General NPI Number Information
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NPI Number | 1578193447
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Entity Type | Individual
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Provider Name | MAYRA POZO NURSE PRACTITIONER
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Gender | Female
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Dates
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Enumeration Date | 01/20/2020
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Last Update Date | 01/20/2020
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Provider Practice Location Address
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Address Line | 1000 10TH AVE STE 10C
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City | NEW YORK
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State | NY
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Zip | 10019-1147
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Country | US
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Telephone | 212-523-8335
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Fax |
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Provider Business Mailing Address
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Address Line | 110 GROVE ST APT 2C
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City | BROOKLYN
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State | NY
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Zip | 11221-4422
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Country | US
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Telephone | 347-202-3626
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | F343203-1
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License Number State | NY
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