Provider Demographics
NPI:1467749150
Name:FRANCIS-OATES, ITA
Entity Type:Individual
Prefix:
First Name:ITA
Middle Name:
Last Name:FRANCIS-OATES
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 1:1066 MAHOPAC RD
Mailing Address - Street 2:
Mailing Address - City:WEST HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11552-4336
Mailing Address - Country:US
Mailing Address - Phone:516-710-5351
Mailing Address - Fax:
Practice Address - Street 1:1066 MAHOPAC RD
Practice Address - Street 2:
Practice Address - City:WEST HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11552-4336
Practice Address - Country:US
Practice Address - Phone:516-710-5351
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-01
Last Update Date:2011-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY265046-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse