# MM NURSE PRACTITIONER IN FAMILY HEALTH PLLC

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

## Provider details

- **NPI number:** 1679465025
- **Authorized official:** MR. MAKROUS M MASHREKY FNP (NURSE PRACTITIONER)
- **Authorized official phone:** (347) 278-3824

## Contact information

- **Practice address:** 7726 62ND ST, GLENDALE, NY 11385-6810
- **Practice address phone:** (347) 278-3824
- **Mailing address:** 7726 62ND ST, GLENDALE, NY 11385-6810
- **Mailing address phone:** (347) 278-3824

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LA2200X | Adult Health Nurse Practitioner | — | NULL | Yes |
| 363LA2200X | Adult Health Nurse Practitioner | — | — | Yes |
| 363LC1500X | Community Health Nurse Practitioner | — | NULL | — |
| 363LC1500X | Community Health Nurse Practitioner | — | — | — |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 07/18/2025
- **Last updated:** 07/18/2025