Provider Demographics
NPI:1235546144
Name:DOCTOR, EMILY LOUISE (DNP, FNP-BC)
Entity Type:Individual
Prefix:MS
First Name:EMILY
Middle Name:LOUISE
Last Name:DOCTOR
Suffix:
Gender:F
Credentials:DNP, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 FIRST AVE
Mailing Address - Street 2:SUITE 10S
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016
Mailing Address - Country:US
Mailing Address - Phone:212-263-3166
Mailing Address - Fax:212-263-8969
Practice Address - Street 1:530 FIRST AVE
Practice Address - Street 2:SUITE 10S
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016
Practice Address - Country:US
Practice Address - Phone:212-263-3166
Practice Address - Fax:212-263-8969
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-14
Last Update Date:2021-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY339323363LF0000X, 363LF0000X
TX792592390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program