Provider Demographics
NPI:1154803567
Name:PINHEIRO, KIA MONETTE (NP)
Entity type:Individual
Prefix:
First Name:KIA
Middle Name:MONETTE
Last Name:PINHEIRO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:KIA
Other - Middle Name:
Other - Last Name:ANTHONY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:177 DENTON PL
Mailing Address - Street 2:
Mailing Address - City:ROOSEVELT
Mailing Address - State:NY
Mailing Address - Zip Code:11575-1519
Mailing Address - Country:US
Mailing Address - Phone:516-974-2634
Mailing Address - Fax:
Practice Address - Street 1:177 DENTON PL
Practice Address - Street 2:
Practice Address - City:ROOSEVELT
Practice Address - State:NY
Practice Address - Zip Code:11575-1519
Practice Address - Country:US
Practice Address - Phone:516-974-2634
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-31
Last Update Date:2018-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY308048363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care