Provider Demographics
NPI:1902670573
Name:EVEREST NP IN FAMILY HEALTH PLLC
Entity Type:Organization
Organization Name:EVEREST NP IN FAMILY HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LOKENDRA
Authorized Official - Middle Name:MATI
Authorized Official - Last Name:RAI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:929-867-2165
Mailing Address - Street 1:4135 67TH ST UNIT MD1
Mailing Address - Street 2:
Mailing Address - City:WOODSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11377-3718
Mailing Address - Country:US
Mailing Address - Phone:929-867-2165
Mailing Address - Fax:
Practice Address - Street 1:4135 67TH ST UNIT MD1
Practice Address - Street 2:
Practice Address - City:WOODSIDE
Practice Address - State:NY
Practice Address - Zip Code:11377-3718
Practice Address - Country:US
Practice Address - Phone:929-867-2165
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-14
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty