MEDICARE: MR. VON LOUIE FOZ FNP

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	163W00000X	Registered Nurse	726973	NY

General Provider Information

NPI Number	:	1124978820
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. VON LOUIE FOZ FNP

Provider Business Mailing Address
First Line	:	219 BRONX RIVER RD APT 1C
Second Line	:
City	:	YONKERS
State	:	NY
Zip	:	10704-3707
Country	:	US
Telephone Number	:	845-668-0588
Fax Number	:

Provider Business Practice Location Address
First Line	:	219 BRONX RIVER RD APT 1C
Second Line	:
City	:	YONKERS
State	:	NY
Zip	:	10704-3707
Country	:	US
Telephone Number	:	845-668-0588
Fax Number	:

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

Provider Enumeration Date	:	02/02/2026
Last Update Date	:	02/02/2026

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