Healthcare Provider Details

I. General information

NPI: 1861656605
Provider Name (Legal Business Name): VANESSA HILDA POOLE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2008
Last Update Date: 07/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PRESBYTERIAN 3959 BROADWAY MORGAN STANLEY CHILDREN'S HOSPITAL OF NEW YORK
NEW YORK NY
10032-3735
US

IV. Provider business mailing address

1020 GRAND CONCOURSE APT 8K
BRONX NY
10451-2605
US

V. Phone/Fax

Practice location:
  • Phone: 212-297-5741
  • Fax:
Mailing address:
  • Phone: 347-726-4920
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License NumberF381957-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: