Provider Demographics
NPI:1629544226
Name:PEART- STEWART, ALDENE
Entity Type:Individual
Prefix:
First Name:ALDENE
Middle Name:
Last Name:PEART- STEWART
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 1:9227 KAUFMAN PL
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11236-5205
Mailing Address - Country:US
Mailing Address - Phone:347-363-8992
Mailing Address - Fax:
Practice Address - Street 1:9227 KAUFMAN PLACE
Practice Address - Street 2:APT 1
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11236-5205
Practice Address - Country:US
Practice Address - Phone:347-363-8992
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-22
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY331458-1164W00000X
NY782016163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse