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General NPI Number Information
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NPI Number | 1851784953
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Entity Type | Organization
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Legal Business Name | VISITING NP IN FAMILY HEALTH, PLLC
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Dates
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Enumeration Date | 03/12/2015
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Last Update Date | 03/12/2015
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Provider Practice Location Address
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Address Line | 169 KNICKERBOCKER AVE
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City | BROOKLYN
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State | NY
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Zip | 11237-2032
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Country | US
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Telephone | 718-644-6944
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Fax | 347-240-2719
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Provider Business Mailing Address
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Address Line | 169 KNICKERBOCKER AVE
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City | BROOKLYN
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State | NY
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Zip | 11237-2032
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Country | US
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Telephone | 718-644-6944
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Fax | 347-240-2719
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. CUMANDA DELROCIO ANGUSTIA
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Credential | NP
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Telephone | 718-644-6944
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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 | 337028
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License Number State | NY
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