1942338124 NPI number — MS. MARY JONES PARKER MS, CPNP

Table of content: MS. MARY JONES PARKER MS, CPNP (NPI 1942338124)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942338124 NPI number — MS. MARY JONES PARKER MS, CPNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PARKER
Provider First Name:
MARY
Provider Middle Name:
JONES
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MS, CPNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
JONES PARKER
Provider Other First Name:
MARY
Provider Other Middle Name:
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
RN MS CPNP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1942338124
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/29/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
222 SEELEY ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BROOKLYN
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11218-1208
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-871-0660
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
180 6TH AVE
Provider Second Line Business Practice Location Address:
LUTHERAN FHCN SCHOOL HEALTH PROGRAM
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11217-3507
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-230-5707
Provider Business Practice Location Address Fax Number:
718-230-7546
Provider Enumeration Date:
03/01/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LP0200X , with the licence number:  F380225-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QS1000X , with the licence number: F380225-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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