Provider Demographics
NPI:1013604172
Name:EUCLID FAMILY HEALTH NP PLLC
Entity Type:Organization
Organization Name:EUCLID FAMILY HEALTH NP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:TACARDON
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:718-603-9228
Mailing Address - Street 1:42 EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:MATAWAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07747-2405
Mailing Address - Country:US
Mailing Address - Phone:718-603-9101
Mailing Address - Fax:718-603-9228
Practice Address - Street 1:348 DAVIS AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10310-1548
Practice Address - Country:US
Practice Address - Phone:718-603-9101
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-19
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty