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Provider Information for 1831335058

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know


Gender: FEMALE

Individual NPI: 1831335058

Calendar   Last Updated:  2008-12-17
  Certification Date: 


Name Value
NPI 1831335058
Enumeration Date 2008-12-17
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 16902 144TH AVE
JAMAICA, NY 11434-5904
United States

Phone: 718-977-1766 | Fax:
View Map External Link
Primary Practice Address 8268 164TH ST QUEENS CANCER CENTER
JAMAICA, NY 11432-1121
United States

Phone: 718-883-3000 | Fax:
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Primary Taxonomy Selected Taxonomy State License Number
Yes 363LA2200X - Nurse Practitioner Adult Health NY F304985-1