Provider Demographics
NPI:1033984521
Name:HOUSE, DAVID J (RN)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:J
Last Name:HOUSE
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:395 FORT WASHINGTON AVE APT 46
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-6729
Mailing Address - Country:US
Mailing Address - Phone:206-321-0278
Mailing Address - Fax:
Practice Address - Street 1:133 MORNINGSIDE AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10027-4802
Practice Address - Country:US
Practice Address - Phone:718-606-3863
Practice Address - Fax:718-361-5199
Is Sole Proprietor?:No
Enumeration Date:2023-11-15
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY589870163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse