Provider Demographics
NPI:1548942774
Name:EVALINE OBARE FAMILY HEALTH NURSE PRACTITIONER PC
Entity type:Organization
Organization Name:EVALINE OBARE FAMILY HEALTH NURSE PRACTITIONER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:EVALINE
Authorized Official - Middle Name:AWUOR
Authorized Official - Last Name:OBARE
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:914-374-8096
Mailing Address - Street 1:111 HIGH ST APT A
Mailing Address - Street 2:
Mailing Address - City:PEEKSKILL
Mailing Address - State:NY
Mailing Address - Zip Code:10566-2809
Mailing Address - Country:US
Mailing Address - Phone:914-374-8096
Mailing Address - Fax:
Practice Address - Street 1:111 HIGH ST APT A
Practice Address - Street 2:
Practice Address - City:PEEKSKILL
Practice Address - State:NY
Practice Address - Zip Code:10566-2809
Practice Address - Country:US
Practice Address - Phone:914-374-8096
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-07
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty