Raven Simone James
Nurse Practitioner, Pediatrics in Brooklyn, NY. Individual provider (NPI-1).
NPI number1245936244
StatusActive
Last updated in NPPESFeb 1, 2023
Details
- NPI
- 1245936244
- Entity type
- Individual (NPI-1)
- Name
- Raven Simone James
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Feb 1, 2023
- Certification date
- Feb 1, 2023
- Last updated
- Feb 1, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0200X | Nurse Practitioner, Pediatrics | 383381 | NY | Yes |
Practice location
2107 Ditmas AveBrooklyn, NY 11226-6903
Phone 718-462-8100
Mailing address
2107 Ditmas AveBrooklyn, NY 11226-6903
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