MEDICARE: AR NP IN FAMILY HEALTH PLLC

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	363LP2300X	Primary Care Nurse Practitioner

General Provider Information

NPI Number	:	1154003408
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AR NP IN FAMILY HEALTH PLLC

Provider Business Mailing Address
First Line	:	12415 116TH AVE APT 1
Second Line	:
City	:	SOUTH OZONE PARK
State	:	NY
Zip	:	11420-2522
Country	:	US
Telephone Number	:	347-866-6117
Fax Number	:

Provider Business Practice Location Address
First Line	:	4024 76TH ST STE 1AB
Second Line	:
City	:	ELMHURST
State	:	NY
Zip	:	11373-1009
Country	:	US
Telephone Number	:	347-866-6117
Fax Number	:

Authorized Official
Title or Position	:	MD
Name	:	ANNETA RAMCHARRAN
Credential	:
Telephone Number	:	347-866-6117

Provider Enumeration Date	:	08/07/2023
Last Update Date	:	08/07/2023

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