Provider Demographics
NPI:1699192666
Name:DAVID, TASHINA (RN)
Entity Type:Individual
Prefix:
First Name:TASHINA
Middle Name:
Last Name:DAVID
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4709 OSMAN PL
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10470-1312
Mailing Address - Country:US
Mailing Address - Phone:212-361-9220
Mailing Address - Fax:
Practice Address - Street 1:4709 OSMAN PL
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10470-1312
Practice Address - Country:US
Practice Address - Phone:212-361-9220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-27
Last Update Date:2014-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY665101163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse