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NPI Code Detail

MEDICARE: ELEMENT FAMILY HEALTH NP PLLC

MEDICARE: ELEMENT 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
1261QP2300XPrimary Care Clinic/Center

General Provider Information

NPI Number : 1740087592
Entity Type Code : Organization
Provider Name (Legal Business Name) : ELEMENT FAMILY HEALTH NP PLLC
Provider Business Mailing Address
First Line : 11906 224TH ST
Second Line :
City : CAMBRIA HEIGHTS
State : NY
Zip : 11411-2112
Country : US
Telephone Number : 646-320-8037
Fax Number :
Provider Business Practice Location Address
First Line : 181 HAWTHORNE ST APT 1F
Second Line :
City : BROOKLYN
State : NY
Zip : 11225-5833
Country : US
Telephone Number : 646-320-8037
Fax Number :
Authorized Official
Title or Position : CLINICIAN /CEO
Name : MRS. TIFFANY R BACCHUS
Credential : FNP-BC
Telephone Number : 646-320-8037
Provider Enumeration Date : 02/28/2025
Last Update Date : 03/08/2025

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Directions to “ELEMENT FAMILY HEALTH NP PLLC ” Practice Location

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