Provider Demographics
NPI:1538684360
Name:KALYUZHNY, BRITTNI ALEXANDRA (FNP)
Entity Type:Individual
Prefix:MRS
First Name:BRITTNI
Middle Name:ALEXANDRA
Last Name:KALYUZHNY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MRS
Other - First Name:BRITTNI
Other - Middle Name:ALEXANDRA
Other - Last Name:KALYUZHNY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP
Mailing Address - Street 1:1324 VICTORY BLVD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10301-3917
Mailing Address - Country:US
Mailing Address - Phone:718-448-4488
Mailing Address - Fax:
Practice Address - Street 1:1324 VICTORY BLVD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10301-3917
Practice Address - Country:US
Practice Address - Phone:718-448-4488
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-14
Last Update Date:2019-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY342207363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily