Provider Demographics
NPI:1497419139
Name:BOND, PAMELA SUE (RN)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:SUE
Last Name:BOND
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 W 128TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10027-3111
Mailing Address - Country:US
Mailing Address - Phone:814-779-1741
Mailing Address - Fax:
Practice Address - Street 1:19 W 128TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10027-3111
Practice Address - Country:US
Practice Address - Phone:814-779-1741
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-28
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY433134163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse