1154473700 NPI number — MRS. DARCUS WHITE WHETSTONE FNP

Table of content: MRS. DARCUS WHITE WHETSTONE FNP (NPI 1154473700)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154473700 NPI number — MRS. DARCUS WHITE WHETSTONE FNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WHETSTONE
Provider First Name:
DARCUS
Provider Middle Name:
WHITE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
FNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1154473700
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1063 E 221ST ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BRONX
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10469-1231
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-881-6059
Provider Business Mailing Address Fax Number:
718-654-1775

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
506 MALCOLM X BLVD
Provider Second Line Business Practice Location Address:
HARLEM HOSPITAL MEDICAL CL RHB 3RD FLOOR
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10037-1802
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-939-8410
Provider Business Practice Location Address Fax Number:
212-939-3892
Provider Enumeration Date:
01/16/2007

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: 363LF0000X , with the licence number:  F330686 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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