Davese Deomi Black
Registered Nurse in Massapequa, NY. Individual provider (NPI-1).
NPI number1548827488
StatusActive
Last updated in NPPESJun 11, 2019
Details
- NPI
- 1548827488
- Entity type
- Individual (NPI-1)
- Name
- Davese Deomi Black
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- May 27, 2019
- Last updated
- Jun 11, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 163W00000X | Registered Nurse | 611477-1 | NY | Yes |
Practice location
4238 Merrick RdMassapequa, NY 11758-6016
Phone 516-900-1978
Mailing address
4238 Merrick RdMassapequa, NY 11758-6016
Phone 516-900-1978
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All 39 Registered Nurse providers in Massapequa · All 1,530 providers in Massapequa
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