Provider Demographics
NPI:1205068582
Name:BARTHOLOMEW, HENRIETTA (RN)
Entity type:Individual
Prefix:MS
First Name:HENRIETTA
Middle Name:
Last Name:BARTHOLOMEW
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1075 EAST 73RD STREET APT 1
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234
Mailing Address - Country:US
Mailing Address - Phone:347-231-4631
Mailing Address - Fax:718-444-4681
Practice Address - Street 1:1075 E 73RD ST APT 1
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-5362
Practice Address - Country:US
Practice Address - Phone:347-231-4631
Practice Address - Fax:718-713-4852
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-20
Last Update Date:2011-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY578026163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse