Provider Demographics
NPI:1558122531
Name:ALAMO, JADE
Entity Type:Individual
Prefix:MS
First Name:JADE
Middle Name:
Last Name:ALAMO
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 1:105 AVENUE P APT 1D
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11204-6257
Mailing Address - Country:US
Mailing Address - Phone:315-664-5708
Mailing Address - Fax:
Practice Address - Street 1:105 AVENUE P APT 1D
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11204-6257
Practice Address - Country:US
Practice Address - Phone:315-664-5708
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-17
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1021182374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide