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Individual

MS. BETTY ELOISA STEWART

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
11706 225TH ST FL 1, CAMBRIA HEIGHTS, NY 11411-1706
(718) 712-8511
Mailing address
11706 225TH ST FL 1, CAMBRIA HEIGHTS, NY 11411-1706
(718) 712-8511

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
334723
NY
363LP2300X
Primary Care Nurse Practitioner
Primary
F334723-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00334723
NY
05
02732209
NY
Enumeration date
01/20/2009
Last updated
11/30/2016
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