MEDICARE: CAMILLE LETFORD

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	174H00000X	Health Educator		NY

General Provider Information

NPI Number	:	1760159537
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAMILLE LETFORD

Provider Business Mailing Address
First Line	:	557 GRAND CONCOURSE STE 4130
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10451-5253
Country	:	US
Telephone Number	:	917-348-1748
Fax Number	:

Provider Business Practice Location Address
First Line	:	8 W 126TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10027-3811
Country	:	US
Telephone Number	:	917-348-1748
Fax Number	:

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

Provider Enumeration Date	:	08/27/2021
Last Update Date	:	08/27/2021

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Directions to “ CAMILLE LETFORD ” Practice Location

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