Individual provider · Type 1 NPI

Timothy Ezadhe

Licensed Practical Nurse · Staten Island, NY

NPI number 1053684340 Active

Practice location

151 Jersey St, APT.1D
Staten Island, NY 10301-1464

Call (347) 785-3270 Map

Mailing address

151 Jersey Street, APT.1D
Staten Island, NY 10301

Specialties and licenses

TaxonomyCodeLicense
Licensed Practical Nurse Primary 164W00000X306157-1 (NY)

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.

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About NPI 1053684340

Timothy Ezadhe's National Provider Identifier is 1053684340, issued on Feb 16, 2012. The primary taxonomy on file is Licensed Practical Nurse (164W00000X), and the practice location is in Staten Island, NY. The record was last updated on Feb 16, 2012.