Provider Demographics
NPI:1528727716
Name:DENOBREGA, STEVALECI M (RN)
Entity type:Individual
Prefix:
First Name:STEVALECI
Middle Name:M
Last Name:DENOBREGA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 E 129TH ST APT 6F
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10035-1122
Mailing Address - Country:US
Mailing Address - Phone:347-952-6422
Mailing Address - Fax:
Practice Address - Street 1:248 W 108TH ST FL 6
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-2956
Practice Address - Country:US
Practice Address - Phone:212-663-3000
Practice Address - Fax:212-865-5347
Is Sole Proprietor?:No
Enumeration Date:2021-12-15
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY73430401163WH0200X, 163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
No163WH0200XNursing Service ProvidersRegistered NurseHome Health