MEDICARE: ANDREA CAROLINA IBANEZ ARTEAGA NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	342532	NY

General Provider Information

NPI Number	:	1063145266
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA CAROLINA IBANEZ ARTEAGA NP

Provider Business Mailing Address
First Line	:	6712 218TH ST APT 1A
Second Line	:
City	:	OAKLAND GARDENS
State	:	NY
Zip	:	11364-2609
Country	:	US
Telephone Number	:	718-962-4088
Fax Number	:

Provider Business Practice Location Address
First Line	:	6712 218TH ST APT 1A
Second Line	:
City	:	OAKLAND GARDENS
State	:	NY
Zip	:	11364-2609
Country	:	US
Telephone Number	:	718-962-4088
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/05/2022
Last Update Date	:	04/02/2026

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