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NPI Code Detail

MEDICARE: DR. DAISY MEDINA-KREPPEIN NURSE PRACTITIONER

MEDICARE: DR. DAISY MEDINA-KREPPEIN NURSE PRACTITIONER
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
1163W00000XRegistered Nurse491154NY
2363LF0000XFamily Nurse Practitioner334130NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1487656112
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAISY MEDINA-KREPPEIN NURSE PRACTITIONER
Provider Business Mailing Address
First Line : 8315 98TH ST
Second Line : APT 2C
City : WOODHAVEN
State : NY
Zip : 11421-1601
Country : US
Telephone Number : 718-850-5077
Fax Number :
Provider Business Practice Location Address
First Line : 2280 N OCEAN AVE
Second Line : INSIDE KMART
City : FARMINGVILLE
State : NY
Zip : 11738-2911
Country : US
Telephone Number : 631-282-8450
Fax Number : 631-320-1300
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/12/2005
Last Update Date : 08/16/2013

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