Provider Demographics
NPI:1154746139
Name:ESTIVERNE, ALOURDES (RN,BSN)
Entity type:Individual
Prefix:
First Name:ALOURDES
Middle Name:
Last Name:ESTIVERNE
Suffix:
Gender:F
Credentials:RN,BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2730 W 33RD ST
Mailing Address - Street 2:4 D
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11224-1666
Mailing Address - Country:US
Mailing Address - Phone:646-842-7213
Mailing Address - Fax:
Practice Address - Street 1:2730 W 33RD ST APT 4D
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11224-1600
Practice Address - Country:US
Practice Address - Phone:646-842-7213
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-27
Last Update Date:2014-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY678107-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse