Provider Demographics
NPI:1265871875
Name:NAZARIO, POOJA (LPN)
Entity type:Individual
Prefix:MRS
First Name:POOJA
Middle Name:
Last Name:NAZARIO
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2526 HUMPHREY ST
Mailing Address - Street 2:
Mailing Address - City:EAST ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11369-1621
Mailing Address - Country:US
Mailing Address - Phone:646-525-0227
Mailing Address - Fax:
Practice Address - Street 1:211 CENTRAL PARK W APT 18E
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-6020
Practice Address - Country:US
Practice Address - Phone:212-988-7677
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-17
Last Update Date:2013-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY311139164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse