Healthcare Provider Details

I. General information

NPI: 1932242930
Provider Name (Legal Business Name): CLAUDIA JANE NELSON M.D. M.P.H.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2920 BROADWAY MAIL CODE 2606 ALFRED LERNER HALL
NEW YORK NY
10027-7004
US

IV. Provider business mailing address

2920 BROADWAY MAIL CODE 2606 ALFRED LERNER HALL
NEW YORK NY
10027
US

V. Phone/Fax

Practice location:
  • Phone: 212-854-2878
  • Fax: 212-854-9473
Mailing address:
  • Phone: 212-854-2878
  • Fax: 212-854-9473

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number228455-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: