Provider Demographics
NPI:1609382829
Name:NAVARRO, BRIAN KENNETH (APN)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:KENNETH
Last Name:NAVARRO
Suffix:
Gender:M
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:622 W 168TH ST PH 111102
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-3720
Mailing Address - Country:US
Mailing Address - Phone:212-305-5976
Mailing Address - Fax:212-305-6193
Practice Address - Street 1:161 FT. WASHINGTON AVE
Practice Address - Street 2:COLUMBIA ORTHOPEDICS - 2ND FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032
Practice Address - Country:US
Practice Address - Phone:212-305-5976
Practice Address - Fax:212-305-6193
Is Sole Proprietor?:No
Enumeration Date:2017-12-26
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00739100363LF0000X
NYF341688-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily