Provider Demographics
NPI:1033732698
Name:LIVING WATER NP IN FAMILY HEALTH PLLC
Entity Type:Organization
Organization Name:LIVING WATER NP IN FAMILY HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:ESTHER
Authorized Official - Middle Name:
Authorized Official - Last Name:ROMILUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-513-7462
Mailing Address - Street 1:78 MARGARET DR
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-1741
Mailing Address - Country:US
Mailing Address - Phone:917-513-7462
Mailing Address - Fax:
Practice Address - Street 1:78 MARGARET DR
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580-1741
Practice Address - Country:US
Practice Address - Phone:917-513-7462
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-18
Last Update Date:2020-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty