Provider Demographics
NPI:1689936155
Name:MILFORT, EVELINE (MS ED/ TSHH)
Entity Type:Individual
Prefix:
First Name:EVELINE
Middle Name:
Last Name:MILFORT
Suffix:
Gender:F
Credentials:MS ED/ TSHH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1316 EGGERT PL
Mailing Address - Street 2:
Mailing Address - City:FAR ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11691-2308
Mailing Address - Country:US
Mailing Address - Phone:718-868-2943
Mailing Address - Fax:
Practice Address - Street 1:1316 EGGERT PL
Practice Address - Street 2:
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11691-2308
Practice Address - Country:US
Practice Address - Phone:718-868-2943
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-11
Last Update Date:2012-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist