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NPI Code Detail

MEDICARE: HOLLY LEE F.N.P.

MEDICARE: HOLLY LEE F.N.P.
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
1363LF0000XFamily Nurse PractitionerF332125NY

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 : 1609859750
Entity Type Code : Individual
Provider Name (Legal Business Name) : HOLLY LEE F.N.P.
Provider Business Mailing Address
First Line : 125 WALKER ST FL 2
Second Line :
City : NEW YORK
State : NY
Zip : 10013-4135
Country : US
Telephone Number : 212-226-8866
Fax Number : 212-226-2289
Provider Business Practice Location Address
First Line : 13626 37TH AVE
Second Line :
City : FLUSHING
State : NY
Zip : 11354-6533
Country : US
Telephone Number : 718-886-1200
Fax Number : 718-886-3901
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/22/2005
Last Update Date : 06/13/2019

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