Healthcare Provider Details

I. General information

NPI: 1134405582
Provider Name (Legal Business Name): YVROSE BREVIL JOSEPH RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: YVROSE BREVIL RN

II. Dates (important events)

Enumeration Date: 10/31/2011
Last Update Date: 02/11/2025
Certification Date: 02/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

89 BARTLETT ST
BROOKLYN NY
11206-4463
US

IV. Provider business mailing address

89 BARTLETT ST
BROOKLYN NY
11206-4463
US

V. Phone/Fax

Practice location:
  • Phone: 718-828-2666
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number550148-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code163WG0600X
TaxonomyGerontology Registered Nurse
License Number550148-1
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN9601079
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: