Individual
FEN HE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
730 58TH ST, BROOKLYN, NY 11220-3917
(718) 567-8811
(347) 243-8190
Mailing address
730 58TH ST, BROOKLYN, NY 11220-3917
(718) 567-8811
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
F421405-01
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
F421405-01
—
NY
Enumeration date
03/05/2020
Last updated
03/05/2020
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