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General NPI Number Information
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NPI Number | 1619476157
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Entity Type | Individual
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Provider Name | ANA ELIZABETH GOTAY FNP
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Gender | Female
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Dates
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Enumeration Date | 02/11/2018
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Last Update Date | 02/11/2018
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Provider Practice Location Address
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Address Line | 754 E 151ST ST
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City | BRONX
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State | NY
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Zip | 10455-3267
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Country | US
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Telephone | 718-299-1100
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Fax |
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Provider Business Mailing Address
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Address Line | 13 VANAMEE ST
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City | NEWBURGH
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State | NY
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Zip | 12550-4049
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Country | US
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Telephone | 718-662-1857
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 342606
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License Number State | NY
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