- Practice location
- 6910 11TH Ave, Brooklyn, NY 11228-1298
- Phone
- 718-836-0012
- Fax
- —
- Last updated
- August 12, 2026
Ethy Canon is a Nurse Practitioner, Family based in Brooklyn, NY. Ethy Canon practices in Brooklyn, NY. The NPI Number for Ethy Canon is 1558139543 and holds a License No. 423223 (NY). The current practice location address for Ethy Canon is 6910 11TH Ave, Brooklyn, NY 11228-1298 and can be reached out via phone at 718-836-0012.
Provider Profile Details
- NPI Number
- 1558139543
- Provider Name
- Ethy Canon
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 6910 11TH Ave, Brooklyn, NY 11228-1298
- Phone Number
- 718-836-0012
- Primary Taxonomy
- Nurse Practitioner, Family · 363LF0000X
- Sole Proprietor
- No
- Provider Enumeration Date
- December 19, 2023
- Last Update Date
- August 12, 2026
- Certification Date
- August 12, 2026
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 6910 11TH Ave
Brooklyn, NY 11228-1298 - City
- Brooklyn
- State
- New York
- Zip
- 11228-1298
- Phone Number
- 718-836-0012
Provider Business Mailing Address Details
- Address
- 302 W 148TH St Apt 3A
New York, NY 10039-2927 - City
- New York
- State
- NY
- Zip
- 10039-2927
- Phone Number
- 646-714-5511
License Information
- License Number
- 423223
- License State
- NY
- Taxonomy
- Nurse Practitioner, Family · 363LF0000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Ethy Canon?
The NPI number of Ethy Canon is 1558139543. It was assigned on December 19, 2023 and is currently active in the NPPES registry.
What is the specialty of Ethy Canon?
Ethy Canon is registered under the primary taxonomy Nurse Practitioner, Family (code 363LF0000X), licensed in NY under license number 423223.
Where does Ethy Canon practice?
The practice location is 6910 11TH Ave, Brooklyn, NY 11228-1298. The office can be reached at 718-836-0012 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1558139543 directly on the NPPES registry website.