1215300272 NPI number — MISS COSETTE ANNETTE HAMPTON B.A.

Table of content: MISS COSETTE ANNETTE HAMPTON B.A. (NPI 1215300272)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215300272 NPI number — MISS COSETTE ANNETTE HAMPTON B.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HAMPTON
Provider First Name:
COSETTE
Provider Middle Name:
ANNETTE
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
B.A.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HAMPTON
Provider Other First Name:
COSETTE
Provider Other Middle Name:
ANNETTE
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
B.A
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1215300272
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/12/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
530 WEST 187 STREET
Provider Second Line Business Mailing Address:
JUST ONE BREAK INC
Provider Business Mailing Address City Name:
NEW YORK CITY
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10033-1437
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
609-347-6256
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
530 WEST 187 STREET
Provider Second Line Business Practice Location Address:
JUST ONE BREAK INC
Provider Business Practice Location Address City Name:
NEW YORK CITY
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10033-1437
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-347-6256
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/12/2015

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: 103TA0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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