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General NPI Number Information
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NPI Number | 1669596078
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Entity Type | Individual
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Provider Name | JOHN ARTHUR NELSON CPNP, PHD
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Gender | Male
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 10/09/2012
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Provider Practice Location Address
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Address Line | 21 AUDUBON AVENUE
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City | NEW YORK
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State | NY
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Zip | 10032
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Country | US
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Telephone | 212-342-3207
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Fax |
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Provider Business Mailing Address
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Address Line | 215 W 125TH ST
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City | NEW YORK
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State | NY
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Zip | 10027-4426
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Country | US
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Telephone | 646-284-9727
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Fax | 646-284-9729
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | F380811
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License Number State | NY
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