Provider Demographics
NPI:1306496344
Name:MCDONALD, NESHIA LATOYA (RN)
Entity type:Individual
Prefix:
First Name:NESHIA
Middle Name:LATOYA
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:NESHIA
Other - Middle Name:LATOYA
Other - Last Name:MCDONALD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:127 BENSON AVE
Mailing Address - Street 2:
Mailing Address - City:ELMONT
Mailing Address - State:NY
Mailing Address - Zip Code:11003-2307
Mailing Address - Country:US
Mailing Address - Phone:718-908-9347
Mailing Address - Fax:
Practice Address - Street 1:127 BENSON AVE
Practice Address - Street 2:
Practice Address - City:ELMONT
Practice Address - State:NY
Practice Address - Zip Code:11003-2307
Practice Address - Country:US
Practice Address - Phone:718-908-9347
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-11
Last Update Date:2019-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY699145163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse