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Provider Information for 1437667201

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know


Gender: FEMALE

Individual NPI: 1437667201

Calendar   Last Updated:  2018-01-16
  Certification Date: 


Name Value
NPI 1437667201
Enumeration Date 2018-01-16
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 33 BLEVINS AVE
MIDDLETOWN, NJ 07748-3168
United States

Phone: 718-913-0468 | Fax:
View Map External Link
Primary Practice Address 3914 15TH AVE
BROOKLYN, NY 11218-4410
United States

Phone: 718-853-9700 | Fax:
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Primary Taxonomy Selected Taxonomy State License Number
Yes 174400000X - Specialist