| Organization Name: | FAMILY HEALTH NURSE PRACTITIONER HOME VISITS PC |
| NPI Number: | 1083942544 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ALEXANDER KOTOV (MEDICAL DIRECTOR) |
| Mailing Address: | 9605 220th St Queens Village |
| State: | NY US |
| Postal Code: | 114291347 |
| Phone Number: | 6462018985 |
| Fax Number: | |
| NPI Enumeration Date: | 11/21/2009 |
| NPI Last Update Date: | 01/12/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | F333427-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |