Provider Demographics
NPI:1952728255
Name:PEREDO, FRANCES JOHANNA (FNP)
Entity Type:Individual
Prefix:MRS
First Name:FRANCES
Middle Name:JOHANNA
Last Name:PEREDO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:DR
Other - First Name:AIJAZ
Other - Middle Name:
Other - Last Name:KHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:187 DOT CT E
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11572-5920
Mailing Address - Country:US
Mailing Address - Phone:516-764-3310
Mailing Address - Fax:516-766-0918
Practice Address - Street 1:187 DOT CT E
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:NY
Practice Address - Zip Code:11572-5920
Practice Address - Country:US
Practice Address - Phone:516-764-3310
Practice Address - Fax:516-766-0918
Is Sole Proprietor?:No
Enumeration Date:2014-03-25
Last Update Date:2014-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY338588363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily