Provider Demographics
NPI:1801600630
Name:NY FAMILY HEALTH NP SERVICES PC
Entity type:Organization
Organization Name:NY FAMILY HEALTH NP SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:MR
Authorized Official - First Name:YAKOV
Authorized Official - Middle Name:
Authorized Official - Last Name:NISIMOV
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:718-415-5494
Mailing Address - Street 1:7925 150TH ST APT A20
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-3803
Mailing Address - Country:US
Mailing Address - Phone:718-415-5494
Mailing Address - Fax:
Practice Address - Street 1:6333 98TH PL APT 3C
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-2317
Practice Address - Country:US
Practice Address - Phone:718-415-5494
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-03
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty