Organization
PORT JERVIS FAMILY HEALTH NP PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELE M DOYLE FNP (NURSE PRACTITIONER/OWNER)
(845) 856-6671
Entity
Organization
Contact information
Practice address
1 COLE ST, PORT JERVIS, NY 12771-2217
(845) 856-6671
(845) 856-6671
Mailing address
7 SURREY RD, CHESTER, NY 10918-1106
(845) 325-8378
(845) 858-9903
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
337610
NY
261QP2300X
Primary Care Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05103104
—
NY
05
—
1035162650001
—
PA
05
—
1902344492
—
NY
05
—
1942551890
—
NY
Enumeration date
12/08/2017
Last updated
07/09/2020
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