Provider Demographics
NPI:1760789697
Name:LITCHMORE, TONI N
Entity Type:Individual
Prefix:
First Name:TONI
Middle Name:N
Last Name:LITCHMORE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3262 HONE AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10469-3808
Mailing Address - Country:US
Mailing Address - Phone:646-660-1851
Mailing Address - Fax:
Practice Address - Street 1:3262 HONE AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10469-3808
Practice Address - Country:US
Practice Address - Phone:646-660-1851
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-11
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY652769163W00000X
CT180076163W00000X
NY294659-1164W00000X
NY347250363LF0000X
CT10112363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse