Provider Demographics
NPI:1932969987
Name:DEPAY, PHILOMENA (RN)
Entity Type:Individual
Prefix:MS
First Name:PHILOMENA
Middle Name:
Last Name:DEPAY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:PHILOMENA
Other - Middle Name:
Other - Last Name:ASOMAH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2565 PEARSALL AVE PH
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10469-5351
Mailing Address - Country:US
Mailing Address - Phone:347-448-7704
Mailing Address - Fax:
Practice Address - Street 1:2565 PEARSALL AVE PH
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10469-5351
Practice Address - Country:US
Practice Address - Phone:347-448-7704
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-19
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY923895163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse