Provider Demographics
NPI:1881241149
Name:CUNNINGHAM, ANGELA CHRISTINE (FNP-BC)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:CHRISTINE
Last Name:CUNNINGHAM
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:CHRISTINE
Other - Last Name:SEAWRIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:630 W 168TH ST # 4
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-3725
Mailing Address - Country:US
Mailing Address - Phone:646-317-6313
Mailing Address - Fax:646-317-6340
Practice Address - Street 1:161 FORT WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3729
Practice Address - Country:US
Practice Address - Phone:646-317-6313
Practice Address - Fax:646-317-6340
Is Sole Proprietor?:No
Enumeration Date:2019-08-21
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY344581363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily