Provider Demographics
NPI:1255659439
Name:FLEARY-ALEXIS, VERNA (FNP)
Entity Type:Individual
Prefix:MRS
First Name:VERNA
Middle Name:
Last Name:FLEARY-ALEXIS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:379 LINCOLN RD
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11225-4358
Mailing Address - Country:US
Mailing Address - Phone:718-953-0422
Mailing Address - Fax:718-953-0422
Practice Address - Street 1:379 LINCOLN RD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11225-4358
Practice Address - Country:US
Practice Address - Phone:718-953-0422
Practice Address - Fax:718-953-0422
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-12
Last Update Date:2010-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF335411364SF0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF335411OtherNURSE PRACTITTIONER IN FAMILY HEALTH