Healthcare Provider Details

I. General information

NPI: 1386565166
Provider Name (Legal Business Name): NEPHTALIE SANDRA KAFKARA JOSEPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

569 CLOCKS BLVD
MASSAPEQUA NY
11758-7716
US

IV. Provider business mailing address

569 CLOCKS BLVD
MASSAPEQUA NY
11758-7716
US

V. Phone/Fax

Practice location:
  • Phone: 786-813-9307
  • Fax: 786-813-9307
Mailing address:
  • Phone: 786-813-9307
  • Fax: 786-813-9307

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberN33256
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: