Healthcare Provider Details

I. General information

NPI: 1467763243
Provider Name (Legal Business Name): MADRID TURENNE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/28/2010
Last Update Date: 06/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3706 AVENUE D
BROOKLYN NY
11203-5608
US

IV. Provider business mailing address

3706 AVENUE D
BROOKLYN NY
11203-5608
US

V. Phone/Fax

Practice location:
  • Phone: 718-856-7313
  • Fax:
Mailing address:
  • Phone: 718-856-7313
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number372734
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: