Provider Demographics
NPI:1225579170
Name:OASIS NURSE PRACTITIONER IN ADULT HEALTH PC
Entity Type:Organization
Organization Name:OASIS NURSE PRACTITIONER IN ADULT HEALTH PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR/EMPLOYEE
Authorized Official - Prefix:
Authorized Official - First Name:EUFEMIA
Authorized Official - Middle Name:NUNEZ
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:ANP-BC
Authorized Official - Phone:516-582-6111
Mailing Address - Street 1:84-11 QUEENS BLVD 1ST FLOOR
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373
Mailing Address - Country:US
Mailing Address - Phone:929-522-0841
Mailing Address - Fax:929-522-0843
Practice Address - Street 1:84-11 QUEENS BOULEVARD FL 1
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-4246
Practice Address - Country:US
Practice Address - Phone:929-522-0841
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-12
Last Update Date:2018-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY304705261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service