| Organization Name: | STAY HEALTHY, NP IN ADULT HEALTH PC |
| NPI Number: | 1144513813 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LEONID KOL (OWNER) |
| Mailing Address: | 13876 Queens Blvd 1st Floor Briarwood |
| State: | NY US |
| Postal Code: | 114352930 |
| Phone Number: | 7188506345 |
| Fax Number: | 7185594896 |
| NPI Enumeration Date: | 05/27/2011 |
| NPI Last Update Date: | 05/27/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | F304465 |
| 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: | |