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Individual

ROBERT TERRELONGE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RN

Contact information

Practice address
791 DREW ST, BROOKLYN, NY 11208
(347) 755-5214
Mailing address
791 DREW ST, BROOKLYN, NY 11208-4703
(347) 755-5214

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
648536
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
402484
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
648536
SERVICE PROVIDERS
NY
Enumeration date
12/26/2016
Last updated
07/30/2018
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