Provider Demographics
NPI:1861944381
Name:BECERRA, KALAYAAN FE SANO (NP)
Entity type:Individual
Prefix:
First Name:KALAYAAN FE
Middle Name:SANO
Last Name:BECERRA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:KALAYAAN FE
Other - Middle Name:ORTIZ
Other - Last Name:SANO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:7901 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-1329
Mailing Address - Country:US
Mailing Address - Phone:718-334-5058
Mailing Address - Fax:718-334-5006
Practice Address - Street 1:7901 BROADWAY
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-1329
Practice Address - Country:US
Practice Address - Phone:718-334-5058
Practice Address - Fax:718-334-5006
Is Sole Proprietor?:No
Enumeration Date:2016-11-01
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY548726163W00000X
NYF307857363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse