Healthcare Provider Details

I. General information

NPI: 1255744074
Provider Name (Legal Business Name): NATOYA TRENCHFIELD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2014
Last Update Date: 06/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

678 SAINT NICHOLAS AVE APT 35
NEW YORK NY
10030-1042
US

IV. Provider business mailing address

678 SAINT NICHOLAS AVE APT 35
NEW YORK NY
10030-1042
US

V. Phone/Fax

Practice location:
  • Phone: 917-600-3155
  • Fax:
Mailing address:
  • Phone: 917-600-3155
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number684566
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: