Healthcare Provider Details

I. General information

NPI: 1073746855
Provider Name (Legal Business Name): MRS. HULDAH PRIMO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HULDAH JULIEN REGISTERED NURSE

II. Dates (important events)

Enumeration Date: 08/27/2009
Last Update Date: 08/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1030 CRESCENT ST
BROOKLYN NY
11208-5520
US

IV. Provider business mailing address

1030 CRESCENT ST
BROOKLYN NY
11208
US

V. Phone/Fax

Practice location:
  • Phone: 347-615-2282
  • Fax:
Mailing address:
  • Phone: 347-615-2282
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number568338
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number568338
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number568338
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number568338
License Number StateNY
# 5
Primary TaxonomyN
Taxonomy Code163WI0500X
TaxonomyInfusion Therapy Registered Nurse
License Number568338
License Number StateNY
# 6
Primary TaxonomyN
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License Number568338
License Number StateNY
# 7
Primary TaxonomyN
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number568338
License Number StateNY
# 8
Primary TaxonomyN
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number568338
License Number StateNY
# 9
Primary TaxonomyN
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number568338
License Number StateNY
# 10
Primary TaxonomyN
Taxonomy Code163WR0400X
TaxonomyRehabilitation Registered Nurse
License Number568338
License Number StateNY
# 11
Primary TaxonomyN
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License Number568338
License Number StateNY
# 12
Primary TaxonomyN
Taxonomy Code163WW0101X
TaxonomyAmbulatory Women's Health Care Registered Nurse
License Number568338
License Number StateNY
# 13
Primary TaxonomyN
Taxonomy Code163WX0003X
TaxonomyInpatient Obstetric Registered Nurse
License Number568338
License Number StateNY
# 14
Primary TaxonomyN
Taxonomy Code163WX1500X
TaxonomyOstomy Care Registered Nurse
License Number568338
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: