Provider Demographics
NPI:1134460371
Name:KING, ALMA JO (NP)
Entity Type:Individual
Prefix:
First Name:ALMA
Middle Name:JO
Last Name:KING
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1595 ODELL ST
Mailing Address - Street 2:4G
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462-7055
Mailing Address - Country:US
Mailing Address - Phone:718-597-2804
Mailing Address - Fax:
Practice Address - Street 1:612 ALLERTON AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-7404
Practice Address - Country:US
Practice Address - Phone:718-519-4125
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-13
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY420654163W00000X
NYF431959-01363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163W00000XNursing Service ProvidersRegistered Nurse