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General NPI Number Information
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NPI Number | 1295078483
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Entity Type | Individual
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Provider Name | JERICKA DANIELS
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Gender | Female
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Dates
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Enumeration Date | 04/05/2013
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Last Update Date | 12/24/2024
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Provider Practice Location Address
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Address Line | 2811 QUEENS PLZ N
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City | LONG ISLAND CITY
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State | NY
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Zip | 11101-4172
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Country | US
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Telephone | 646-225-8441
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Fax |
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Provider Business Mailing Address
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Address Line | 2426 LURTING AVE
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City | BRONX
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State | NY
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Zip | 10469-4404
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Country | US
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Telephone |
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Fax |
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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 | 163WA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Registered Nurse
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License Number | 9516976
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 163WC0400X
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Taxonomy Name | Case Management Registered Nurse
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License Number | 726905-1
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number | 9516976
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 307677-1
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License Number State | NY
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Taxonomy #5
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Taxonomy Code | 163WS0200X
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Taxonomy Name | School Registered Nurse
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License Number | 307677
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License Number State | NY
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