Provider Demographics
NPI:1952998429
Name:HAMLIN, ARETHA EYSIA (NP)
Entity type:Individual
Prefix:MRS
First Name:ARETHA
Middle Name:EYSIA
Last Name:HAMLIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MRS
Other - First Name:ARETHA
Other - Middle Name:EYSIA
Other - Last Name:HAMLIN-HARDY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP
Mailing Address - Street 1:19 FRAZIER ST
Mailing Address - Street 2:
Mailing Address - City:HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11550-6917
Mailing Address - Country:US
Mailing Address - Phone:516-305-9598
Mailing Address - Fax:
Practice Address - Street 1:121 DEKALB AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-5425
Practice Address - Country:US
Practice Address - Phone:718-250-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-30
Last Update Date:2020-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY403350363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health