1093568818 NPI number — MISS AKILAH FLORETTE LINTON PRATT

Table of content: MISS AKILAH FLORETTE LINTON PRATT (NPI 1093568818)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093568818 NPI number — MISS AKILAH FLORETTE LINTON PRATT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PRATT
Provider First Name:
AKILAH
Provider Middle Name:
FLORETTE LINTON
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
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:
1093568818
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/16/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
23 COWPER AVENUE, COLLEGE GREEN
Provider Second Line Business Mailing Address:
HOPE PASTURE
Provider Business Mailing Address City Name:
KINGSTON 6
Provider Business Mailing Address State Name:
KINGSTON
Provider Business Mailing Address Postal Code:
JMAKN06
Provider Business Mailing Address Country Code:
JM
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
111 EAST 210 STREET
Provider Second Line Business Practice Location Address:
PARKWAY
Provider Business Practice Location Address City Name:
BRONX
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10467
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-696-2583
Provider Business Practice Location Address Fax Number:
718-881-5074
Provider Enumeration Date:
04/10/2024

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: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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