Provider Demographics
NPI:1881479509
Name:BROBBEY, PRISCILLA OWUSU (FNP)
Entity type:Individual
Prefix:
First Name:PRISCILLA
Middle Name:OWUSU
Last Name:BROBBEY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 MIRIAM PKWY
Mailing Address - Street 2:
Mailing Address - City:ELMONT
Mailing Address - State:NY
Mailing Address - Zip Code:11003-4427
Mailing Address - Country:US
Mailing Address - Phone:347-836-3999
Mailing Address - Fax:
Practice Address - Street 1:23 WATER GRANT ST
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-3582
Practice Address - Country:US
Practice Address - Phone:347-836-3999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-30
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY750508163WC0200X
NYF351810363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine