Provider Demographics
NPI:1275674319
Name:NODIFF, DEBRA (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:
Last Name:NODIFF
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 E 98TH ST
Mailing Address - Street 2:BOX 1170
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-6501
Mailing Address - Country:US
Mailing Address - Phone:212-241-8470
Mailing Address - Fax:212-241-4611
Practice Address - Street 1:1176 5TH AVE
Practice Address - Street 2:E LEVEL, BOX 1170
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6503
Practice Address - Country:US
Practice Address - Phone:212-659-8557
Practice Address - Fax:212-369-2385
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-10
Last Update Date:2009-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF360263176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife