1538436787 NPI number — MISS HAZELDINE EUDORA CLAXTON B.S.

Table of content: MISS HAZELDINE EUDORA CLAXTON B.S. (NPI 1538436787)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538436787 NPI number — MISS HAZELDINE EUDORA CLAXTON B.S.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CLAXTON
Provider First Name:
HAZELDINE
Provider Middle Name:
EUDORA
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
B.S.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MATTHEW
Provider Other First Name:
VERA
Provider Other Middle Name:
ELMOSA
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
B.S.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1538436787
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/16/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
135 EINSTEIN LOOP
Provider Second Line Business Mailing Address:
#46
Provider Business Mailing Address City Name:
BRONX
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10475-4974
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-320-3082
Provider Business Mailing Address Fax Number:
718-379-4348

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
135 EINSTEIN LOOP
Provider Second Line Business Practice Location Address:
#46
Provider Business Practice Location Address City Name:
BRONX
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10475-4974
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-320-3082
Provider Business Practice Location Address Fax Number:
718-379-4348
Provider Enumeration Date:
11/16/2011

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: 104100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com