Individual
KATHY AZEVEDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
WHNP-BC
Contact information
Practice address
1275 YORK AVE, NEW YORK, NY 10065-6007
(212) 639-2000
Mailing address
11949 UNION TPKE APT 5E, FOREST HILLS, NY 11375-6109
(917) 542-1578
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
F421372-1
NY
Other
Enumeration date
10/14/2019
Last updated
10/14/2019
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