Healthcare Provider Details

I. General information

NPI: 1508284779
Provider Name (Legal Business Name): NORMA OCAMPO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2014
Last Update Date: 03/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

158-13 72ND AVENUE
FRESH MEADOWS NY
11365-1022
US

IV. Provider business mailing address

15813 72ND AVE
FRESH MEADOWS NY
11365-1140
US

V. Phone/Fax

Practice location:
  • Phone: 718-380-7600
  • Fax:
Mailing address:
  • Phone: 718-380-7600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: