Provider Demographics
NPI:1033368204
Name:IANKOWITZ, NANCY ELLEN (DNP, FNP-BC)
Entity type:Individual
Prefix:DR
First Name:NANCY
Middle Name:ELLEN
Last Name:IANKOWITZ
Suffix:
Gender:F
Credentials:DNP, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 GREAT BEAR RD
Mailing Address - Street 2:
Mailing Address - City:HOLMES
Mailing Address - State:NY
Mailing Address - Zip Code:12531-5326
Mailing Address - Country:US
Mailing Address - Phone:917-716-6802
Mailing Address - Fax:
Practice Address - Street 1:24 GREAT BEAR RD
Practice Address - Street 2:
Practice Address - City:HOLMES
Practice Address - State:NY
Practice Address - Zip Code:12531-5326
Practice Address - Country:US
Practice Address - Phone:917-716-6802
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-12
Last Update Date:2016-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF330293-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF330293-1OtherLICENSE