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General NPI Number Information
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NPI Number | 1689565194
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Entity Type | Organization
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Legal Business Name | QUEENS NEIGHBORHOOD NP IN FAMILY AND WOMENS HEALTH CARE PLLC
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Dates
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Enumeration Date | 07/12/2025
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Last Update Date | 07/12/2025
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Provider Practice Location Address
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Address Line | 3022 MERRICK RD
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City | WANTAGH
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State | NY
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Zip | 11793-4320
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Country | US
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Telephone | 631-867-2695
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Fax |
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Provider Business Mailing Address
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Address Line | 3022 MERRICK RD
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City | WANTAGH
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State | NY
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Zip | 11793-4320
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | EMPLOYEE
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Name | JEAN MARIE
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Credential |
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Telephone | 631-867-2695
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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