# AGING WELL RN NP FAMILY HEALTH PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1629202478
- **Authorized official:** MS. AZZA A EZZAT NP (PRESIDENT)
- **Authorized official phone:** (717) 716-7107

## Contact information

- **Practice address:** 774 MANOR RD, STATEN ISLAND, NY 10314-7038
- **Practice address phone:** (718) 496-2542
- **Mailing address:** 796 RATHBUN AVE, STATEN ISLAND, NY 10309-2409
- **Mailing address phone:** (717) 716-7107

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP2300X | Primary Care Nurse Practitioner | — | NY | Yes |

## Other

- **Enumeration date:** 05/07/2009
- **Last updated:** 04/24/2026