Provider Demographics
NPI:1447957006
Name:PAHLAEF, DEVORA B
Entity type:Individual
Prefix:
First Name:DEVORA
Middle Name:B
Last Name:PAHLAEF
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 1:19710C 65TH CRES
Mailing Address - Street 2:
Mailing Address - City:FRESH MEADOWS
Mailing Address - State:NY
Mailing Address - Zip Code:11365-4069
Mailing Address - Country:US
Mailing Address - Phone:347-549-5666
Mailing Address - Fax:
Practice Address - Street 1:19710C 65TH CRES
Practice Address - Street 2:
Practice Address - City:FRESH MEADOWS
Practice Address - State:NY
Practice Address - Zip Code:11365-4069
Practice Address - Country:US
Practice Address - Phone:347-549-5666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-13
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY78229901163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse