Provider Demographics
NPI:1841620705
Name:LAMOTHE, YVESBERLIE
Entity type:Individual
Prefix:
First Name:YVESBERLIE
Middle Name:
Last Name:LAMOTHE
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 1:428 W 26TH ST APT 11H
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-5605
Mailing Address - Country:US
Mailing Address - Phone:917-815-3890
Mailing Address - Fax:
Practice Address - Street 1:428 W 26TH ST APT 11H
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-5605
Practice Address - Country:US
Practice Address - Phone:917-815-3890
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-13
Last Update Date:2021-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3142861-1164W00000X
NY726444-01163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse