Individual
MONIQUE C. LUCKETT-CUMMINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
10 WOODS RD, VALHALLA, NY 10595-1529
(917) 371-8441
(914) 231-1203
Mailing address
3650 VARIAN AVE, BRONX, NY 10466-5935
(917) 371-8441
Taxonomy
Speciality
Code
Description
License number
State
163WC1600X
Continuing Education/Staff Development Registered Nurse
658951
NY
363L00000X
Nurse Practitioner
Primary
348196
NY
363LF0000X
Family Nurse Practitioner
658951
NY
Other
Enumeration date
04/24/2021
Last updated
12/12/2021
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