Provider Demographics
NPI:1114668969
Name:DAYS NURSE PRACTITIONER IN FAMILY HEALTH P.C.
Entity Type:Organization
Organization Name:DAYS NURSE PRACTITIONER IN FAMILY HEALTH P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:SHENGJIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-881-0690
Mailing Address - Street 1:15751 19TH AVE
Mailing Address - Street 2:
Mailing Address - City:WHITESTONE
Mailing Address - State:NY
Mailing Address - Zip Code:11357-3820
Mailing Address - Country:US
Mailing Address - Phone:917-881-0690
Mailing Address - Fax:929-362-2083
Practice Address - Street 1:14210 ROOSEVELT AVE STE P10
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-6000
Practice Address - Country:US
Practice Address - Phone:929-362-2082
Practice Address - Fax:929-362-2083
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-05
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02265465Medicaid