Healthcare Provider Details

I. General information

NPI: 1063867729
Provider Name (Legal Business Name): CAMEIKA NADINE THOMPSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2016
Last Update Date: 04/04/2026
Certification Date: 04/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3331 SEYMOUR AVE APT 1
BRONX NY
10469-2955
US

IV. Provider business mailing address

3331 SEYMOUR AVE APT 1
BRONX NY
10469-2955
US

V. Phone/Fax

Practice location:
  • Phone: 917-733-1393
  • Fax:
Mailing address:
  • Phone: 917-733-1393
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number7135231
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number351563
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: