Provider Demographics
NPI:1639819246
Name:TURKMANI, ILSE BERENICE
Entity Type:Individual
Prefix:MRS
First Name:ILSE
Middle Name:BERENICE
Last Name:TURKMANI
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:PO BOX 674
Mailing Address - Street 2:
Mailing Address - City:WINDHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12496-0674
Mailing Address - Country:US
Mailing Address - Phone:929-232-4423
Mailing Address - Fax:
Practice Address - Street 1:78 BUCKSKIN LOOP
Practice Address - Street 2:
Practice Address - City:WINDHAM
Practice Address - State:NY
Practice Address - Zip Code:12496
Practice Address - Country:US
Practice Address - Phone:929-232-4423
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-31
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032755-01225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist