Provider Demographics
NPI:1821348046
Name:FEELEY-ESSOKA, KATARINA MALAIKA (FNP)
Entity Type:Individual
Prefix:MRS
First Name:KATARINA
Middle Name:MALAIKA
Last Name:FEELEY-ESSOKA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MS
Other - First Name:KATARINA
Other - Middle Name:MALAIKA
Other - Last Name:FEELEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP
Mailing Address - Street 1:242 WOODLANDS DRIVE
Mailing Address - Street 2:
Mailing Address - City:TUXEDO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:10987
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:242 WOODLANDS DRIVE
Practice Address - Street 2:
Practice Address - City:TUXEDO PARK
Practice Address - State:NY
Practice Address - Zip Code:10987
Practice Address - Country:US
Practice Address - Phone:845-753-9555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-14
Last Update Date:2012-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF337033-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily