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General NPI Number Information
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NPI Number | 1437835980
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Entity Type | Individual
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Provider Name | CAMILLE IMANI HENDRICKS RN
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Gender | Female
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Dates
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Enumeration Date | 06/27/2023
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Last Update Date | 06/27/2023
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Provider Practice Location Address
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Address Line | 3411 WAYNE AVE
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City | BRONX
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State | NY
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Zip | 10467-2509
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Country | US
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Telephone | 914-426-7699
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Fax |
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Provider Business Mailing Address
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Address Line | 4029 BARNES AVE # 3
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City | BRONX
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State | NY
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Zip | 10466-4309
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Country | US
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Telephone | 914-426-7699
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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 | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number | 846009
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 163WG0100X
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Taxonomy Name | Gastroenterology Registered Nurse
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License Number | 846009
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License Number State | NY
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