Provider Demographics
NPI:1578789723
Name:FRUMESS NURSE PRACTITIONER FAMILY HEALTH PLLC
Entity Type:Organization
Organization Name:FRUMESS NURSE PRACTITIONER FAMILY HEALTH PLLC
Other - Org Name:CORNER CARE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRINCIPAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:NAOMI
Authorized Official - Middle Name:C
Authorized Official - Last Name:FRUMESS
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:845-439-8371
Mailing Address - Street 1:10401 N MERIDIAN ST
Mailing Address - Street 2:STE 310
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46290-1151
Mailing Address - Country:US
Mailing Address - Phone:317-428-4379
Mailing Address - Fax:
Practice Address - Street 1:43 MAIN STREET
Practice Address - Street 2:
Practice Address - City:LIVINGSTON MANOR
Practice Address - State:NY
Practice Address - Zip Code:12758
Practice Address - Country:US
Practice Address - Phone:845-439-8371
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty