CRYSTAL BROADHEAD (NPI# 1639640501) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639640501 |
| Entity Type | Individual |
| Full Name | CRYSTAL BROADHEAD |
| Practice Address |
110 W 97th St New York NY 10025-6450 |
| Mailing Address |
75 Cumberland Walk Apt 13h Brooklyn NY 11205-2171 |
| Practice Telephone | 2127491820 |
| Enumeration Date | 2018-12-17 |
| Last Update Date | 2018-12-17 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 164W00000X | Licensed Practical Nurse | 303542 | NY | Nursing Service Providers |
| Y | 164W00000X | Licensed Practical Nurse | 303542-1 | NY | Nursing Service Providers |
| Street Address |
110 W 97TH ST |
| City | NEW YORK |
| State | NY |
| Zip Code | 10025-6450 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740253723 | Alexandrina Chetreanu | Internal Medicine | 110 W 97th St, New York, NY 10025-6450 | 2006-02-09 |
| 1598364366 | Arleigh Jane Salce | Registered Nurse | 110 W 97th St, New York, NY 10025-6450 | 2020-10-22 |
| 1275143000 | Carline Mondesir Laroche | Licensed Practical Nurse | 110 W 97th St, New York, NY 10025-6450 | 2020-08-06 |
| 1942819511 | Christopher Faso | Registered Nurse | 110 W 97th St, New York, NY 10025-6450 | 2020-07-29 |
| 1952923658 | Yadira Jimenez | Registered Nurse | 110 W 97th St, New York, NY 10025-6450 | 2020-05-15 |
| 1992340954 | Cassandra Short | Licensed Practical Nurse | 110 W 97th St, New York, NY 10025-6450 | 2019-11-14 |
| 1689234361 | Monica Louise Dreitcer | Registered Nurse | 110 W 97th St, New York, NY 10025-6450 | 2019-06-16 |
| 1467925081 | Brittany Boyce | Licensed Practical Nurse | 110 W 97th St, New York, NY 10025-6450 | 2019-01-07 |
| 1316429327 | Giselle Guzman | Registered Nurse | 110 W 97th St, New York, NY 10025-6450 | 2018-09-06 |
| 1578040879 | Sarah Anne Shih | Family Medicine | 110 W 97th St, New York, NY 10025-6450 | 2018-07-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730795840 | Third Eye Acupuncture P.C. | Acupuncturist | 255 West 94th Street, Apt. 6k, New York, NY 10025 | 2020-09-23 |
| 1326653882 | Clare Elizabeth Dacey | Social Worker | 251 West 98th Street, Apartment 6-b, New York, NY 10025 | 2020-09-11 |
| 1528672870 | Alexandra E Lamm | Psychologist | 50 W 96th Street, Apt 5a-d, New York, NY 10025 | 2020-09-03 |
| 1700402310 | Jean Tully | Counselor | 240 W102nd St., #22a, New York, NY 10025 | 2020-06-19 |
| 1518591692 | Ethan Arthur Baker | Acupuncturist | 309 W. 99th St., Apt. 8b, New York City, NY 10025 | 2020-02-27 |
| 1083258321 | Lisanne Godnick | Social Worker | 210 W 101 St, Nyc, NY 10025 | 2019-10-30 |
| 1558910463 | Cherry Jones | Social Worker | 440 W 114th Street, Clark 6, New York, NY 10025 | 2019-09-04 |
| 1245894674 | Westside Nutrition Pllc | Dietitian, Registered | 240 West 102nd Street, Suite 15, New York, NY 10025 | 2019-05-01 |
| 1518429380 | Nathan Yehuda Ben Agi | Student in an Organized Health Care Education/Training Program | Mt. Sinai St. Lukes, 1111 Amsterdam Avenue, New York, NY 10025 | 2019-04-02 |
| 1366913196 | Mavis H Baird | Counselor | 243 W 99th St #3e, New York, NY 10025 | 2018-12-05 |
| Find all providers in zip 10025 | ||||
| Taxonomy Code | 164W00000X |
| Grouping | Nursing Service Providers |
| Classification | Licensed Practical Nurse |
| An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |
| Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629685904 | Crystal Blue-marino | Licensed Practical Nurse | 2075 3rd Ave, New York, NY 10029-2120 | 2020-09-30 |
| 1396352928 | Alyssa Joan Williams | Licensed Practical Nurse | 371 Fort Washington Ave, New York, NY 10033-6739 | 2020-09-28 |
| 1689280117 | Princess Nailah Blackwell | Licensed Practical Nurse | 2844 Fredrick Douglas Blvd, Apt# 5c, New York, NY 10039 | 2020-09-21 |
| 1255940003 | Emmanuella Charles | Licensed Practical Nurse | 170 Avenue D, New York, NY 10009-4309 | 2020-07-28 |
| 1063038735 | Okeroghene Jude Ikie | Licensed Practical Nurse | 122 W 27th St Fl 4, New York, NY 10001-6271 | 2020-06-18 |
| 1699396945 | Rosa Armstrong Inc | Licensed Practical Nurse | 244 5th Ave # R215, New York, NY 10001-7604 | 2020-04-28 |
| 1952936700 | Elmol P Der | Licensed Practical Nurse | 10 W 119th St Apt 7, New York, NY 10026-1447 | 2020-03-11 |
| 1396385738 | Falilatu Mohammed | Licensed Practical Nurse | 2315 2nd Ave, New York, NY 10035-4160 | 2020-01-14 |
| 1316586290 | Amy Doumbia | Licensed Practical Nurse | 210 W 140th St Apt 5c, New York, NY 10030-1793 | 2019-12-25 |
| 1205474467 | Gayoung Kim | Licensed Practical Nurse | 2279 3rd Ave Apt 3b, New York, NY 10035-2249 | 2019-12-18 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.