Provider Demographics
NPI:1518266691
Name:JOSEPH, DEBRA ANN (RN)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:ANN
Last Name:JOSEPH
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 1:190 HEATHCOTE RD
Mailing Address - Street 2:PH
Mailing Address - City:ELMONT
Mailing Address - State:NY
Mailing Address - Zip Code:11003-2006
Mailing Address - Country:US
Mailing Address - Phone:718-809-1539
Mailing Address - Fax:
Practice Address - Street 1:190 HEATHCOTE RD
Practice Address - Street 2:PH
Practice Address - City:ELMONT
Practice Address - State:NY
Practice Address - Zip Code:11003-2006
Practice Address - Country:US
Practice Address - Phone:718-809-1539
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-15
Last Update Date:2011-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY496568-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse