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General NPI Number Information
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NPI Number | 1588774434
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Entity Type | Individual
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Provider Name | MERLENE GODFREY GNP
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Gender | Female
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 08/04/2014
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Provider Practice Location Address
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Address Line | 374 STOCKHOLM ST
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City | BROOKLYN
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State | NY
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Zip | 11237-4006
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Country | US
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Telephone | 718-486-4221
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Fax | 718-508-4632
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Provider Business Mailing Address
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Address Line | 385 SENECA AVE
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City | REDWOOD
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State | NY
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Zip | 11385
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Country | US
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Telephone | 718-749-1216
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Fax | 718-453-3634
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | F340141
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License Number State | NY
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