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General NPI Number Information
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NPI Number | 1710359179
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Entity Type | Organization
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Legal Business Name | TENDER CARE NP IN FAMILY HEALTH
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Dates
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Enumeration Date | 10/26/2015
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Last Update Date | 11/08/2021
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Provider Practice Location Address
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Address Line | 316 ROCKAWAY PKWY
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City | BROOKLYN
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State | NY
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Zip | 11212-3369
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Country | US
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Telephone | 347-409-6288
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Fax |
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Provider Business Mailing Address
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Address Line | 1141 E 56TH ST
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City | BROOKLYN
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State | NY
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Zip | 11234-2411
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Country | US
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Telephone | 347-409-6288
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Fax |
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Authorized Official
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Title or Position | NP
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Name | KEISHA BURRELL
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Credential |
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Telephone | 347-409-6288
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 33-3372244
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License Number State | NY
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