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General NPI Number Information
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NPI Number | 1750071072
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Entity Type | Organization
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Legal Business Name | ZIKO NURSE PRACTITIONER IN FAMILY HEALTH PC
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Dates
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Enumeration Date | 05/10/2023
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Last Update Date | 06/05/2023
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Provider Practice Location Address
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Address Line | 172 BATHGATE ST
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City | STATEN ISLAND
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State | NY
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Zip | 10312-6021
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Country | US
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Telephone | 718-551-5719
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Fax |
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Provider Business Mailing Address
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Address Line | 172 BATHGATE ST
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City | STATEN ISLAND
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State | NY
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Zip | 10312-6021
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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 | OWNER
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Name | ELDA ZIKO
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Credential | PMHNP-BC
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Telephone | 718-551-5719
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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