Provider Demographics
NPI:1861961005
Name:FELIX, PRADEL FILS (AGPCNP-BC)
Entity type:Individual
Prefix:
First Name:PRADEL
Middle Name:FILS
Last Name:FELIX
Suffix:
Gender:M
Credentials:AGPCNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 SHEEP LN
Mailing Address - Street 2:
Mailing Address - City:LEVITTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11756-4119
Mailing Address - Country:US
Mailing Address - Phone:516-425-2223
Mailing Address - Fax:
Practice Address - Street 1:41 CARRIAGE RD
Practice Address - Street 2:
Practice Address - City:ROSLYN
Practice Address - State:NY
Practice Address - Zip Code:11576-3117
Practice Address - Country:US
Practice Address - Phone:516-425-2223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-16
Last Update Date:2018-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF308909-1363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty