Provider Demographics
NPI:1790058063
Name:HARMON, BEVERLY ANGELA (RN)
Entity Type:Individual
Prefix:MS
First Name:BEVERLY
Middle Name:ANGELA
Last Name:HARMON
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 1:2480 8TH AVE APT 4C
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10027-7708
Mailing Address - Country:US
Mailing Address - Phone:212-690-3820
Mailing Address - Fax:
Practice Address - Street 1:2215 HOLLAND AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-9401
Practice Address - Country:US
Practice Address - Phone:718-549-6700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-17
Last Update Date:2012-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY514541163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse