Provider Demographics
NPI:1194039941
Name:NEKVAPIL, EDWARD JOHN (FNP)
Entity Type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:JOHN
Last Name:NEKVAPIL
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2608 COUNTY ROUTE 1
Mailing Address - Street 2:
Mailing Address - City:PORT JERVIS
Mailing Address - State:NY
Mailing Address - Zip Code:12771-3422
Mailing Address - Country:US
Mailing Address - Phone:845-551-1874
Mailing Address - Fax:845-695-7388
Practice Address - Street 1:42 RYKOWSKI LN
Practice Address - Street 2:SUITE 2
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10941-4018
Practice Address - Country:US
Practice Address - Phone:845-695-7300
Practice Address - Fax:845-695-7388
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-04
Last Update Date:2010-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY335745363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily