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General NPI Number Information
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NPI Number | 1578917068
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Entity Type | Individual
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Provider Name | LAURA MCGUINNESS FNP, MSN
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Gender | Female
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Dates
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Enumeration Date | 04/20/2016
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Last Update Date | 06/09/2017
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Provider Practice Location Address
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Address Line | 2960 VICTORY BLVD
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City | STATEN ISLAND
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State | NY
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Zip | 10314-6605
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Country | US
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Telephone | 917-499-0031
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Fax |
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Provider Business Mailing Address
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Address Line | 166 MEADOW LN
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City | PARAMUS
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State | NJ
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Zip | 07652-5223
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Country | US
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Telephone | 917-499-0031
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F337503-1
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License Number State | NY
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