Provider Demographics
NPI:1598094773
Name:AWAD, ESHRAK J (RN BSN)
Entity Type:Individual
Prefix:MS
First Name:ESHRAK
Middle Name:J
Last Name:AWAD
Suffix:
Gender:F
Credentials:RN BSN
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3135 GODWIN TER
Mailing Address - Street 2:APT#4C
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-5450
Mailing Address - Country:US
Mailing Address - Phone:347-324-2341
Mailing Address - Fax:
Practice Address - Street 1:3135 GODWIN TER
Practice Address - Street 2:APT#4C
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463
Practice Address - Country:US
Practice Address - Phone:347-324-2341
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-16
Last Update Date:2018-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY615908-1163W00000X
NY342899363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse