MEDICARE: MRS. ELLEN M HIGGINS 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	363LW0102X	Women's Health Nurse Practitioner	F3334491	NY

General Provider Information

NPI Number	:	1427265081
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ELLEN M HIGGINS FNP

Provider Business Mailing Address
First Line	:	50 DAYTON LN
Second Line	:	SUITE 202
City	:	PEEKSKILL
State	:	NY
Zip	:	10566-2859
Country	:	US
Telephone Number	:	914-739-0087
Fax Number	:	914-737-1714

Provider Business Practice Location Address
First Line	:	1756 ROUTE 9D
Second Line	:
City	:	COLD SPRING
State	:	NY
Zip	:	10516-2619
Country	:	US
Telephone Number	:	845-809-5661
Fax Number	:	845-809-5663

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

Provider Enumeration Date	:	05/16/2007
Last Update Date	:	09/09/2014

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