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NPI Code Detail

MEDICARE: CHARLOTTE AGBAKLA TAMATEY LPN

MEDICARE:   CHARLOTTE  AGBAKLA TAMATEY  LPN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1164W00000XLicensed Practical Nurse297380NY

General Provider Information

NPI Number : 1134443807
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHARLOTTE AGBAKLA TAMATEY LPN
Provider Business Mailing Address
First Line : 100 ELGAR PL APT 30J
Second Line :
City : BRONX
State : NY
Zip : 10475-5048
Country : US
Telephone Number : 347-863-2918
Fax Number :
Provider Business Practice Location Address
First Line : 29 JOHNSON AVE
Second Line :
City : WHEATLEY HEIGHTS
State : NY
Zip : 11798-2505
Country : US
Telephone Number : 631-790-8827
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/24/2010
Last Update Date : 04/20/2015

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Directions to “ CHARLOTTE AGBAKLA TAMATEY LPN” Practice Location

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