Provider Demographics
NPI:1235911363
Name:ARIAS MUNOZ, BRENDA (LPN)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:
Last Name:ARIAS MUNOZ
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 1:405 E 105TH ST APT 13H
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-5155
Mailing Address - Country:US
Mailing Address - Phone:347-807-5052
Mailing Address - Fax:
Practice Address - Street 1:937 FULTON ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11238-2347
Practice Address - Country:US
Practice Address - Phone:718-789-1212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-13
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY333278-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse