Provider Demographics
NPI:1851171946
Name:REFUSE, PAMELA JEANNY
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:JEANNY
Last Name:REFUSE
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 1:45 E BEVERLY PKWY
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-4204
Mailing Address - Country:US
Mailing Address - Phone:516-590-6800
Mailing Address - Fax:
Practice Address - Street 1:45 E BEVERLY PKWY
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580-4204
Practice Address - Country:US
Practice Address - Phone:516-590-6800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-05
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician