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General NPI Number Information
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NPI Number | 1215238712
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Entity Type | Individual
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Provider Name | LAURETTA MAXINE JOSEPH NP
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Gender | Female
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Dates
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Enumeration Date | 11/15/2010
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Last Update Date | 11/15/2010
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Provider Practice Location Address
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Address Line | 450 CLARKSON AVE # 33
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City | BROOKLYN
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State | NY
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Zip | 11203-2012
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Country | US
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Telephone | 718-270-4456
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Fax | 718-270-2477
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Provider Business Mailing Address
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Address Line | 440 LENOX RD APT.,5S
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City | BROOKLYN
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State | NY
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Zip | 11203-2023
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Country | US
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Telephone | 718-484-0716
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Fax | 718-484-0716
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | F303436
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License Number State | NY
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