Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | F3060291 | NY |
NPI | 1063838795 |
---|---|
Provider Name | Kemesha Scott-Denehy |
First Address | Valley Stream, NY 11580-3221 |
Second Address | Valley Stream, NY 11580-3221 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/03/2014 |
Last Update Date | 05/03/2014 |