Basic Information
| Provider Information | |||||||||
| NPI: | 1437304136 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PREFERRED HEALTH PARTNERS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 32 COURT ST | ||||||||
| Address2: | SUITE 1900 | ||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112014404 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7184228124 | ||||||||
| FaxNumber: | 7184228140 | ||||||||
| Practice Location | |||||||||
| Address1: | 233 NOSTRAND AVENUE | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 11205 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7188265900 | ||||||||
| FaxNumber: | 7188265906 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/21/2008 | ||||||||
| LastUpdateDate: | 11/21/2008 | ||||||||
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| AuthorizedOfficialLastName: | KERNISANT | ||||||||
| AuthorizedOfficialFirstName: | LESLEY | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 7184228030 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 335726 | NY | Y | 193400000X SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.