Provider Demographics
NPI:1013519057
Name:DREW, TAYLOR J (RN, BSN)
Entity Type:Individual
Prefix:MS
First Name:TAYLOR
Middle Name:J
Last Name:DREW
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:372 DEKALB AVE APT 3F
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11205-3812
Mailing Address - Country:US
Mailing Address - Phone:718-450-9242
Mailing Address - Fax:646-906-0404
Practice Address - Street 1:16318 JAMAICA AVE STE 2
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-4901
Practice Address - Country:US
Practice Address - Phone:718-450-9242
Practice Address - Fax:646-905-0404
Is Sole Proprietor?:No
Enumeration Date:2020-11-13
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY707807163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse