Provider Demographics
NPI:1841649795
Name:HARRY, JOYCE MILLICENT X (LPN)
Entity type:Individual
Prefix:MS
First Name:JOYCE
Middle Name:MILLICENT
Last Name:HARRY
Suffix:X
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 1:630 FLUSHING AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11206-5026
Mailing Address - Country:US
Mailing Address - Phone:718-828-2666
Mailing Address - Fax:718-782-1538
Practice Address - Street 1:630 FLUSHING AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11206-5026
Practice Address - Country:US
Practice Address - Phone:718-828-2666
Practice Address - Fax:718-782-1538
Is Sole Proprietor?:No
Enumeration Date:2016-06-10
Last Update Date:2016-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY254187164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY080701937OtherMEDICARE A&B