Provider Demographics
NPI:1831416528
Name:PEART, WINSTON (RN)
Entity type:Individual
Prefix:MR
First Name:WINSTON
Middle Name:
Last Name:PEART
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1704 FLATBUSH AVE
Mailing Address - Street 2:SUITE 196
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11210-3943
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1704 FLATBUSH AVE
Practice Address - Street 2:SUITE 196
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11210-3943
Practice Address - Country:US
Practice Address - Phone:917-385-3859
Practice Address - Fax:646-808-0839
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-21
Last Update Date:2010-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY465281-1163W00000X, 163WC1500X, 163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163W00000XNursing Service ProvidersRegistered Nurse
No163WH0200XNursing Service ProvidersRegistered NurseHome Health