Provider Demographics
NPI:1811253545
Name:BECERRA, ESPERANZA (RN)
Entity type:Individual
Prefix:MS
First Name:ESPERANZA
Middle Name:
Last Name:BECERRA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1665 ST MARKS AVE RM 119
Mailing Address - Street 2:CSE 5
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11233-4813
Mailing Address - Country:US
Mailing Address - Phone:718-812-2212
Mailing Address - Fax:718-240-3759
Practice Address - Street 1:7539 192ND ST
Practice Address - Street 2:FLUSHING
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11366-1859
Practice Address - Country:US
Practice Address - Phone:646-761-3678
Practice Address - Fax:718-240-3759
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-06
Last Update Date:2012-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT374328-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse