Provider Demographics
NPI:1699355123
Name:MCDONALD, NYROBHIE (RN, CMLDT)
Entity Type:Individual
Prefix:
First Name:NYROBHIE
Middle Name:
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:RN, CMLDT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2975 AVENUE W APT 2A
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-5333
Mailing Address - Country:US
Mailing Address - Phone:718-269-9882
Mailing Address - Fax:
Practice Address - Street 1:68 LOIS CT
Practice Address - Street 2:
Practice Address - City:EAST MEADOW
Practice Address - State:NY
Practice Address - Zip Code:11554
Practice Address - Country:US
Practice Address - Phone:718-269-9882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-09
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY776734163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse