MEDICARE: MS. TERREL AMANDA BLACKETT

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
1	171M00000X	Case Manager/Care Coordinator	1261539	NY

General Provider Information

NPI Number	:	1336493923
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. TERREL AMANDA BLACKETT

Provider Business Mailing Address
First Line	:	1086 E 86TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11236-4243
Country	:	US
Telephone Number	:	718-427-1079
Fax Number	:	718-455-5137

Provider Business Practice Location Address
First Line	:	1086 E 86TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11236-4243
Country	:	US
Telephone Number	:	718-427-1079
Fax Number	:	718-455-5137

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/03/2012
Last Update Date	:	11/03/2012

Similar Medicare Providers

1407090277 — MS. CANISIA PALTON OTR/L
Practice Location Address:

1040 E 86TH ST
BROOKLYN, NY
11236-4243

Practice Phone: 718-209-6399
Practice Fax: 718-209-6399

1942939772 — MARIE NOISETTE
Practice Location Address:

1058 E 86TH ST
BROOKLYN, NY
11236-4243

Practice Phone: 347-693-7862
Practice Fax:

1346002656 — SKDG CORPORATION
Practice Location Address:

38 6TH AVE APT 1511
BROOKLYN, NY
11217-4243

Practice Phone: 347-907-9003
Practice Fax:

1922552421 — JULIA RAVINOVA
Practice Location Address:

845 E 96TH ST
BROOKLYN, NY
11236-2105

Practice Phone: 718-922-3505
Practice Fax:

1609381102 — LEVI RAPOPORT MHC
Practice Location Address:

9413 FLATLANDS AVE
BROOKLYN, NY
11236-3726

Practice Phone: 609-779-2418
Practice Fax:

1255294104 — MOAMEN HASSAN
Practice Location Address:

8727 AVENUE D
BROOKLYN, NY
11236-1600

Practice Phone: 718-924-2122
Practice Fax: 718-924-2123

Directions to “ MS. TERREL AMANDA BLACKETT ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.