Provider Demographics
NPI:1457873366
Name:CITRONI, BETH L
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:L
Last Name:CITRONI
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 1:314 JEFFERSON AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11216-1702
Mailing Address - Country:US
Mailing Address - Phone:347-328-3197
Mailing Address - Fax:
Practice Address - Street 1:314 JEFFERSON AVE
Practice Address - Street 2:2ND FL
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11216-1702
Practice Address - Country:US
Practice Address - Phone:347-328-3197
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY682250163W00000X
NY001805176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No163W00000XNursing Service ProvidersRegistered Nurse