Provider Demographics
NPI:1073954210
Name:SAVOY, JADE (LPN)
Entity Type:Individual
Prefix:
First Name:JADE
Middle Name:
Last Name:SAVOY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3961 CARPENTER AVE
Mailing Address - Street 2:# 4A
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10466-3703
Mailing Address - Country:US
Mailing Address - Phone:347-317-1070
Mailing Address - Fax:
Practice Address - Street 1:3961 CARPENTER AVE
Practice Address - Street 2:# 4A
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10466-3703
Practice Address - Country:US
Practice Address - Phone:347-317-1070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-16
Last Update Date:2013-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY313356164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse