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Organization
NOVA FAMILY HEALTH NP, PC
Active
Organization
NOVA FAMILY HEALTH NP, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. VALESSA MESIDOR FNP (OWNER)
(516) 587-4541
Entity
Organization
Contact information
Practice address
1400 WANTAGH AVE, WANTAGH, NY 11793-2257
(516) 308-7405
(516) 308-7404
Mailing address
32 COLUMBIA ST, FARMINGDALE, NY 11735-2606
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07863734
—
NY
01
—
347927
STATE LICENSE
NY
01
—
A400294812
MEDICARE
NY
Enumeration date
09/12/2023
Last updated
07/08/2024
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