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NPI Code Detail

MEDICARE: TABITHA JOY LOCKLEAR-VALERIO FNP-BC

MEDICARE: TABITHA JOY LOCKLEAR-VALERIO FNP-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerF34225701NY
2363LF0000XFamily Nurse Practitioner342257NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1619414802
Entity Type Code : Individual
Provider Name (Legal Business Name) : TABITHA JOY LOCKLEAR-VALERIO FNP-BC
Provider Business Mailing Address
First Line : 202 FOSTER AVE STE A
Second Line :
City : BROOKLYN
State : NY
Zip : 11230-2130
Country : US
Telephone Number : 347-295-1525
Fax Number : 212-658-9759
Provider Business Practice Location Address
First Line : 202 FOSTER AVE STE A
Second Line :
City : BROOKLYN
State : NY
Zip : 11230-2130
Country : US
Telephone Number : 347-295-1525
Fax Number : 212-658-9759
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/25/2017
Last Update Date : 01/03/2023

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Directions to “ TABITHA JOY LOCKLEAR-VALERIO FNP-BC” Practice Location

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