Provider Demographics
NPI:1871138826
Name:WARDE, HORTENSE ANITA
Entity type:Individual
Prefix:
First Name:HORTENSE
Middle Name:ANITA
Last Name:WARDE
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 1:1307 E 83RD ST FL 2
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11236-5101
Mailing Address - Country:US
Mailing Address - Phone:718-444-0574
Mailing Address - Fax:
Practice Address - Street 1:1307 E 83RD ST # 2
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11236-5101
Practice Address - Country:US
Practice Address - Phone:718-444-0574
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-14
Last Update Date:2019-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY413644163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty