Basic Information
Provider Information
NPI: 1801109491
EntityType: 2
ReplacementNPI:  
OrganizationName: HEALTH CARE FOR ALL, NP IN ADULT HEALTH, P.C.
LastName:  
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MiddleName:  
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Credential:  
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Mailing Information
Address1: 13878 QUEENS BLVD
Address2: 1ST FLOOR
City: BRIARWOOD
State: NY
PostalCode: 114352930
CountryCode: US
TelephoneNumber: 7188506345
FaxNumber: 7185267971
Practice Location
Address1: 13876 QUEENS BLVD
Address2: 1ST FLOOR
City: BRIARWOOD
State: NY
PostalCode: 114352930
CountryCode: US
TelephoneNumber: 7188506345
FaxNumber: 7185267971
Other Information
ProviderEnumerationDate: 07/23/2010
LastUpdateDate: 06/20/2018
NPIDeactivationReasonCode:  
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ProviderGenderCode:  
AuthorizedOfficialLastName: KOL
AuthorizedOfficialFirstName: LEONID
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: NURSE PRACTITIONER
AuthorizedOfficialTelephone: 7188506345
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: NP
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
261QC1500XF304465NYY Ambulatory Health Care FacilitiesClinic/CenterCommunity Health

No ID Information.


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