Basic Information
| Provider Information | |||||||||
| NPI: | 1821421074 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | HOPE MOBILE NP-FAMILY HEALTH HOUSE CALL PRACTICE PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4567 CROSSROADS PARK DR | ||||||||
| Address2: | |||||||||
| City: | LIVERPOOL | ||||||||
| State: | NY | ||||||||
| PostalCode: | 130883589 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3152952100 | ||||||||
| FaxNumber: | 3152952125 | ||||||||
| Practice Location | |||||||||
| Address1: | 144 CENTURY DR | ||||||||
| Address2: | |||||||||
| City: | SOLVAY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 132092204 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3152437767 | ||||||||
| FaxNumber: | 3152952125 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/12/2013 | ||||||||
| LastUpdateDate: | 08/12/2013 | ||||||||
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| AuthorizedOfficialLastName: | MURPHY | ||||||||
| AuthorizedOfficialFirstName: | SEAN | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 3152437767 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | FNP-C | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 334169 | NY | Y | 193400000X SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.