MEDICARE: QUALITY CARE FAMILY HEALTH NP 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	363LF0000X	Family Nurse Practitioner

General Provider Information

NPI Number	:	1447196209
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	QUALITY CARE FAMILY HEALTH NP PLLC

Provider Business Mailing Address
First Line	:	2375 RICHMOND RD STE 4
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10306-2352
Country	:	US
Telephone Number	:	646-226-5276
Fax Number	:

Provider Business Practice Location Address
First Line	:	2375 RICHMOND RD STE 4
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10306-2352
Country	:	US
Telephone Number	:	646-226-5276
Fax Number	:

Authorized Official
Title or Position	:	NP
Name	:	CHRYSTAL C FAN
Credential	:	FNP
Telephone Number	:	567-377-6100

Provider Enumeration Date	:	04/24/2026
Last Update Date	:	04/24/2026

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