Basic Information
Provider Information
NPI: 1689755001
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BILLETT
FirstName: HENNY
MiddleName: H
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 38 CLIFTON AVE
Address2:  
City: YONKERS
State: NY
PostalCode: 107053621
CountryCode: US
TelephoneNumber: 8666338255
FaxNumber:  
Practice Location
Address1: MONTEFIORE MEDICAL PARK
Address2: 1575 BLONDELL AVENUE
City: BRONX
State: NY
PostalCode: 10461
CountryCode: US
TelephoneNumber: 8666338255
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/19/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RH0000X124012NYY Allopathic & Osteopathic PhysiciansInternal MedicineHematology

No ID Information.


Home