Provider Demographics
NPI:1316503063
Name:MILORD, JUDE KATIA
Entity type:Individual
Prefix:
First Name:JUDE
Middle Name:KATIA
Last Name:MILORD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12948 HOOK CREEK BLVD
Mailing Address - Street 2:
Mailing Address - City:ROSEDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11422-1123
Mailing Address - Country:US
Mailing Address - Phone:347-985-3773
Mailing Address - Fax:
Practice Address - Street 1:12948 HOOK CREEK BLVD
Practice Address - Street 2:
Practice Address - City:ROSEDALE
Practice Address - State:NY
Practice Address - Zip Code:11422-1123
Practice Address - Country:US
Practice Address - Phone:347-985-3773
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-17
Last Update Date:2019-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY329577164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse