Provider Demographics
NPI:1790148799
Name:NEGRON, BETSY (CPNP)
Entity Type:Individual
Prefix:
First Name:BETSY
Middle Name:
Last Name:NEGRON
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 518
Mailing Address - Street 2:
Mailing Address - City:BRONXVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10708-0518
Mailing Address - Country:US
Mailing Address - Phone:718-329-2275
Mailing Address - Fax:718-329-2276
Practice Address - Street 1:3050 GRAND CONCOURSE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10458-1306
Practice Address - Country:US
Practice Address - Phone:718-329-2275
Practice Address - Fax:718-329-2276
Is Sole Proprietor?:No
Enumeration Date:2016-03-29
Last Update Date:2016-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF380500363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics