Provider Demographics
NPI:1851687479
Name:HENRY, JUDE (RN)
Entity Type:Individual
Prefix:MR
First Name:JUDE
Middle Name:
Last Name:HENRY
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 WASHINGTON AVE
Mailing Address - Street 2:4O
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11225-1041
Mailing Address - Country:US
Mailing Address - Phone:347-799-4657
Mailing Address - Fax:
Practice Address - Street 1:901 WASHINGTON AVE
Practice Address - Street 2:4O
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11225-1041
Practice Address - Country:US
Practice Address - Phone:347-799-4657
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-22
Last Update Date:2014-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY678854163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse