Talita Campos, NP | |
1411 Myrtle Ave, Brooklyn, NY 11237-4512 | |
(718) 907-4301 | |
Not Available |
Full Name | Talita Campos |
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Gender | Female |
Speciality | Nurse Practitioner - Pediatrics |
Location | 1411 Myrtle Ave, Brooklyn, New York |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1780364877 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
163W00000X | Registered Nurse | 827539 (New York) | Secondary |
363LP0200X | Nurse Practitioner - Pediatrics | F383553 (New York) | Primary |
Entity Name | Wyckoff Professional Medical Services Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1659710796 PECOS PAC ID: 6406748607 Enrollment ID: O20040324001805 |
Mailing Address | Practice Location Address |
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Talita Campos, NP 2527 85th St, East Elmhurst, NY 11370-1608 Ph: (917) 957-4891 | Talita Campos, NP 1411 Myrtle Ave, Brooklyn, NY 11237-4512 Ph: (718) 907-4301 |
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