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General NPI Number Information
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NPI Number | 1801017447
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Entity Type | Individual
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Provider Name | EULALEE ELSADA MUIR FNP
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Gender | Female
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Dates
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Enumeration Date | 05/01/2007
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Last Update Date | 09/27/2013
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Provider Practice Location Address
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Address Line | 1650 GRAND CONCOURSE
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City | BRONX
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State | NY
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Zip | 10457
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Country | US
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Telephone | 171-857-9263
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Fax | 718-579-2644
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Provider Business Mailing Address
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Address Line | 757 EAST 80TH ST
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City | BROOKLYN
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State | NY
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Zip | 11236
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Country | US
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Telephone | 718-763-1231
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Fax | 718-579-2644
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | F330432-1
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License Number State | NY
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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 | F330432-1
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License Number State | NY
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