Provider Demographics
NPI:1003109398
Name:BATES, IRMA MARTINA (REGISTERED NURSE)
Entity Type:Individual
Prefix:MRS
First Name:IRMA
Middle Name:MARTINA
Last Name:BATES
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 E RAILROAD AVE
Mailing Address - Street 2:
Mailing Address - City:WEST HAVERSTRAW
Mailing Address - State:NY
Mailing Address - Zip Code:10993-1215
Mailing Address - Country:US
Mailing Address - Phone:845-947-2028
Mailing Address - Fax:
Practice Address - Street 1:49 E RAILROAD AVE
Practice Address - Street 2:
Practice Address - City:WEST HAVERSTRAW
Practice Address - State:NY
Practice Address - Zip Code:10993-1215
Practice Address - Country:US
Practice Address - Phone:845-947-2028
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-19
Last Update Date:2011-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY641357-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse