Organization Name: | FERN BAUDO ADULT HEALTH NURSE PRACTITIONER PC |
NPI Number: | 1114278413 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | FERN BAUDO (PRESIDENT) |
Mailing Address: | 108 Capitol Ave Williston Park |
State: | NY US |
Postal Code: | 115961621 |
Phone Number: | 6462354633 |
Fax Number: | |
NPI Enumeration Date: | 09/26/2012 |
NPI Last Update Date: | 09/26/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2200X |
License Number: | F3303237 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Adult Health |
Taxonomy Definition: |