MEDICARE: DEBBIE HARRIPERSAD 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	363LF0000X	Family Nurse Practitioner	347128	NY

General Provider Information

NPI Number	:	1336714062
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBBIE HARRIPERSAD FNP

Provider Business Mailing Address
First Line	:	12017 95TH AVE
Second Line	:
City	:	SOUTH RICHMOND HILL
State	:	NY
Zip	:	11419-1343
Country	:	US
Telephone Number	:	917-283-8210
Fax Number	:

Provider Business Practice Location Address
First Line	:	12017 95TH AVE
Second Line	:
City	:	SOUTH RICHMOND HILL
State	:	NY
Zip	:	11419-1343
Country	:	US
Telephone Number	:	917-283-8210
Fax Number	:

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

Provider Enumeration Date	:	05/25/2021
Last Update Date	:	05/25/2021

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