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General NPI Number Information
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NPI Number | 1588144364
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Entity Type | Individual
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Provider Name | DESIREE PETAL HOPKINSON NP
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Gender | Female
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Dates
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Enumeration Date | 08/21/2018
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Last Update Date | 12/07/2023
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Provider Practice Location Address
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Address Line | 1 ROCKEFELLER PLZ FL 11
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City | NEW YORK
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State | NY
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Zip | 10020-2073
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Country | US
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Telephone | 646-801-9698
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Fax |
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Provider Business Mailing Address
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Address Line | 1046 ROSEDALE RD
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City | VALLEY STREAM
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State | NY
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Zip | 11581-2747
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Country | US
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Telephone | 516-569-5196
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 402402
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License Number State | NY
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