Provider Demographics
NPI:1346724085
Name:LARBIE, EVELYN WREH
Entity Type:Individual
Prefix:
First Name:EVELYN
Middle Name:WREH
Last Name:LARBIE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16633 89TH AVE APT 10E
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-4237
Mailing Address - Country:US
Mailing Address - Phone:315-572-1483
Mailing Address - Fax:
Practice Address - Street 1:WHITE GLOVE COMMUNITY CARE
Practice Address - Street 2:89 BARTLETT STREET
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11206
Practice Address - Country:US
Practice Address - Phone:718-828-2666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-19
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY333141164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse