Provider Demographics
NPI:1679029110
Name:TAMEKA BREMMER
Entity Type:Organization
Organization Name:TAMEKA BREMMER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE
Authorized Official - Prefix:
Authorized Official - First Name:TAMEKA
Authorized Official - Middle Name:
Authorized Official - Last Name:BREMMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-927-6220
Mailing Address - Street 1:171 W KINGSBRIDGE RD
Mailing Address - Street 2:3RD FL
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10550-4831
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:171 W KINGSBRIDGE RD
Practice Address - Street 2:3RD FL
Practice Address - City:MOUNT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10550-4831
Practice Address - Country:US
Practice Address - Phone:201-927-6220
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-25
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY22712706314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility