Provider Demographics
NPI:1558970434
Name:HOOD, EBONY
Entity Type:Individual
Prefix:MS
First Name:EBONY
Middle Name:
Last Name:HOOD
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 1:11941 FARMERS BLVD # 2
Mailing Address - Street 2:
Mailing Address - City:SAINT ALBANS
Mailing Address - State:NY
Mailing Address - Zip Code:11412-3651
Mailing Address - Country:US
Mailing Address - Phone:646-363-3981
Mailing Address - Fax:
Practice Address - Street 1:11941 FARMERS BLVD # 2
Practice Address - Street 2:
Practice Address - City:SAINT ALBANS
Practice Address - State:NY
Practice Address - Zip Code:11412-3651
Practice Address - Country:US
Practice Address - Phone:646-363-3981
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-27
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator