Provider Demographics
NPI:1528395027
Name:ARISTIDE, BETTY (RN)
Entity Type:Individual
Prefix:MRS
First Name:BETTY
Middle Name:
Last Name:ARISTIDE
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 1:236 W 1ST ST
Mailing Address - Street 2:
Mailing Address - City:DEER PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11729-5956
Mailing Address - Country:US
Mailing Address - Phone:631-940-7591
Mailing Address - Fax:
Practice Address - Street 1:236 W 1ST ST
Practice Address - Street 2:
Practice Address - City:DEER PARK
Practice Address - State:NY
Practice Address - Zip Code:11729-5956
Practice Address - Country:US
Practice Address - Phone:631-940-7591
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-04
Last Update Date:2009-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4653761163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical