Healthcare Provider Details

I. General information

NPI: 1376461459
Provider Name (Legal Business Name): CODIECIA CHRISTENA VASSEL RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

795 LINDEN BLVD APT B2
BROOKLYN NY
11203-3569
US

IV. Provider business mailing address

795 LINDEN BLVD APT B2
BROOKLYN NY
11203-3569
US

V. Phone/Fax

Practice location:
  • Phone: 347-909-1832
  • Fax:
Mailing address:
  • Phone: 347-909-1832
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number970271-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: