Provider Demographics
NPI:1164493771
Name:NAVARRO, THELMA MYERS (FNP)
Entity Type:Individual
Prefix:
First Name:THELMA
Middle Name:MYERS
Last Name:NAVARRO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 E 34TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-4744
Mailing Address - Country:US
Mailing Address - Phone:212-731-5145
Mailing Address - Fax:212-731-5521
Practice Address - Street 1:160 E 34TH ST
Practice Address - Street 2:PERLMUTTER CANCER CENTER
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-4744
Practice Address - Country:US
Practice Address - Phone:212-731-5145
Practice Address - Fax:212-731-5521
Is Sole Proprietor?:No
Enumeration Date:2006-01-31
Last Update Date:2018-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY331113363LF0000X
NYF331113363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02054557Medicaid
NY02054557Medicaid
S88996Medicare UPIN