MEDICARE: HALEY MCDONALD FNP-C

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	354343	NY

General Provider Information

NPI Number	:	1346074572
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HALEY MCDONALD FNP-C

Provider Business Mailing Address
First Line	:	78 YALE PL
Second Line	:
City	:	ROCKVILLE CENTRE
State	:	NY
Zip	:	11570-2836
Country	:	US
Telephone Number	:	516-526-9109
Fax Number	:

Provider Business Practice Location Address
First Line	:	1322 CORTELYOU RD
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11226-5604
Country	:	US
Telephone Number	:	718-213-4738
Fax Number	:

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

Provider Enumeration Date	:	08/29/2024
Last Update Date	:	08/29/2024

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