Provider Demographics
NPI:1790347094
Name:LOW, TRICIA A (RN, BSN)
Entity Type:Individual
Prefix:MS
First Name:TRICIA
Middle Name:A
Last Name:LOW
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:MS
Other - First Name:TRICIA
Other - Middle Name:
Other - Last Name:THOMAS-HOLLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, BSN
Mailing Address - Street 1:11534 126TH ST
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11420-2628
Mailing Address - Country:US
Mailing Address - Phone:610-334-1670
Mailing Address - Fax:
Practice Address - Street 1:451 CLARKSON AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-2054
Practice Address - Country:US
Practice Address - Phone:718-245-3131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-08
Last Update Date:2019-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY683069-1163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency