Provider Demographics
NPI:1578102380
Name:AFUANG, MILALUZ TUBA (RN)
Entity Type:Individual
Prefix:MRS
First Name:MILALUZ
Middle Name:TUBA
Last Name:AFUANG
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:KIRBY FORENSIC PSCHIATRIC CENTER
Mailing Address - Street 2:600 E 125TH STREET
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10035-6095
Mailing Address - Country:US
Mailing Address - Phone:646-672-6805
Mailing Address - Fax:646-672-6898
Practice Address - Street 1:KIRBY FORENSIC PSCHIATRIC CENTER
Practice Address - Street 2:600 E 125TH STREET
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10035-6095
Practice Address - Country:US
Practice Address - Phone:646-672-6805
Practice Address - Fax:646-672-6898
Is Sole Proprietor?:No
Enumeration Date:2019-12-26
Last Update Date:2019-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY404971-1163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health