Provider Demographics
NPI:1730321381
Name:PEARTREE, TONYA LASHAWN
Entity Type:Individual
Prefix:
First Name:TONYA
Middle Name:LASHAWN
Last Name:PEARTREE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TONYA
Other - Middle Name:LASHAWN
Other - Last Name:PEARTREE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN,BSN,CNN
Mailing Address - Street 1:4146 EDSON AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10466-2012
Mailing Address - Country:US
Mailing Address - Phone:718-881-3040
Mailing Address - Fax:
Practice Address - Street 1:4146 EDSON AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10466-2012
Practice Address - Country:US
Practice Address - Phone:718-881-3040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-28
Last Update Date:2009-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY490176163WH0200X, 163WN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WN0300XNursing Service ProvidersRegistered NurseNephrology
No163WH0200XNursing Service ProvidersRegistered NurseHome Health