Basic Information
| Provider Information | |||||||||
| NPI: | 1598101560 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JEUDY | ||||||||
| FirstName: | ASTRIDE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 20826 GRAND CENTRAL PKWY | ||||||||
| Address2: | APT 2A | ||||||||
| City: | QUEENS VILLAGE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 114271557 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7184595592 | ||||||||
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| Practice Location | |||||||||
| Address1: | 20826 GRAND CENTRAL PKWY | ||||||||
| Address2: | APT 2A | ||||||||
| City: | QUEENS VILLAGE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 114271557 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7184595592 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/17/2013 | ||||||||
| LastUpdateDate: | 05/17/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 164W00000X | 287936-1 | NY | Y | Nursing Service Providers | Licensed Practical Nurse |
No ID Information.