Provider Demographics
NPI:1346792629
Name:VERNET, EUMENIDE CHARLES (AGNP)
Entity Type:Individual
Prefix:MRS
First Name:EUMENIDE
Middle Name:CHARLES
Last Name:VERNET
Suffix:
Gender:F
Credentials:AGNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:547 E 85TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11236-3277
Mailing Address - Country:US
Mailing Address - Phone:917-946-7317
Mailing Address - Fax:
Practice Address - Street 1:547 E 85TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11236-3277
Practice Address - Country:US
Practice Address - Phone:917-946-7317
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-02
Last Update Date:2016-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY306366363LA2200X
NY340894363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology