Basic Information
Provider Information
NPI: 1750034153
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GEORGES
FirstName: DAPHNEE
MiddleName: JOHANNE
NamePrefix: MS.
NameSuffix:  
Credential: REGISTERED NURSE
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7901 BROADWAY
Address2:  
City: ELMHURST
State: NY
PostalCode: 113731329
CountryCode: US
TelephoneNumber: 7183343054
FaxNumber:  
Practice Location
Address1: 7901 BROADWAY
Address2:  
City: ELMHURST
State: NY
PostalCode: 113731329
CountryCode: US
TelephoneNumber: 7183343054
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/27/2022
LastUpdateDate: 01/27/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/27/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163WE0003X519417NYY Nursing Service ProvidersRegistered NurseEmergency

No ID Information.


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