Basic Information
Provider Information
NPI: 1841523313
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HOUSLIN-CELESTIN
FirstName: NICOLA
MiddleName:  
NamePrefix: MRS.
NameSuffix:  
Credential: NP-BC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 801 BRADLEY ST
Address2:  
City: WEST HEMPSTEAD
State: NY
PostalCode: 115523609
CountryCode: US
TelephoneNumber: 5162630102
FaxNumber:  
Practice Location
Address1: 9715 64TH RD
Address2:  
City: REGO PARK
State: NY
PostalCode: 113742250
CountryCode: US
TelephoneNumber: 7184595592
FaxNumber: 7184596047
Other Information
ProviderEnumerationDate: 09/15/2009
LastUpdateDate: 02/12/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/12/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LA2200X309731NYY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health

No ID Information.


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