Provider Demographics
NPI:1306149331
Name:MC TOY, GEORGETTE (LPN)
Entity type:Individual
Prefix:MRS
First Name:GEORGETTE
Middle Name:
Last Name:MC TOY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 METROPOLITAN AVE
Mailing Address - Street 2:APT. 3G
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462-6964
Mailing Address - Country:US
Mailing Address - Phone:646-894-0293
Mailing Address - Fax:
Practice Address - Street 1:1700 METROPOLITAN AVE
Practice Address - Street 2:APT. 3G
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10462-6964
Practice Address - Country:US
Practice Address - Phone:646-894-0293
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-14
Last Update Date:2010-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY067805-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse