Healthcare Provider Details

I. General information

NPI: 1679970560
Provider Name (Legal Business Name): JAMES SAINT FORT RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: JAMES ST.FORT RN

II. Dates (important events)

Enumeration Date: 11/21/2014
Last Update Date: 09/29/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13 CLEVELAND ST
VALLEY STREAM NY
11580-6003
US

IV. Provider business mailing address

9612 AVENUE N
BROOKLYN NY
11236-5306
US

V. Phone/Fax

Practice location:
  • Phone: 347-893-7983
  • Fax:
Mailing address:
  • Phone: 347-893-7983
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number684826
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: