Provider Demographics
NPI:1023213139
Name:EUGENE, KLAVDIA
Entity Type:Individual
Prefix:
First Name:KLAVDIA
Middle Name:
Last Name:EUGENE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16215 HIGHLAND AVE APT 6C
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-3460
Mailing Address - Country:US
Mailing Address - Phone:718-883-0744
Mailing Address - Fax:718-739-5577
Practice Address - Street 1:16215 HIGHLAND AVE APT 6C
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-3460
Practice Address - Country:US
Practice Address - Phone:718-883-0744
Practice Address - Fax:718-739-5577
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant