Provider Demographics
NPI:1144610320
Name:HILAIRE, FARAH (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:FARAH
Middle Name:
Last Name:HILAIRE
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11631 205TH ST FL 2
Mailing Address - Street 2:
Mailing Address - City:SAINT ALBANS
Mailing Address - State:NY
Mailing Address - Zip Code:11412-2930
Mailing Address - Country:US
Mailing Address - Phone:347-481-5644
Mailing Address - Fax:
Practice Address - Street 1:11631 205TH ST FL 2
Practice Address - Street 2:
Practice Address - City:SAINT ALBANS
Practice Address - State:NY
Practice Address - Zip Code:11412-2930
Practice Address - Country:US
Practice Address - Phone:347-481-5644
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-27
Last Update Date:2019-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF338680363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily