Healthcare Provider Details

I. General information

NPI: 1114397510
Provider Name (Legal Business Name): MISS NATHALIE OHAYON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2015
Last Update Date: 09/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1623 KINGS HWY
BROOKLYN NY
11229
US

IV. Provider business mailing address

1623 KINGS HWY
BROOKLYN NY
11229
US

V. Phone/Fax

Practice location:
  • Phone: 718-375-1200
  • Fax:
Mailing address:
  • Phone: 718-375-1200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number0
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: