EREWARIFAGHA MININI HAIDOME

JAMAICA, NY
NPI1114301728
Professional NameEREWARI MININI PETERSIDE
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: NY  403564)
Additional Taxonomies163W00000X Registered Nurse
(Licence: NY  621055-1)
Enumeration Date2015-07-13
Last Update Date2023-11-02
Business Address
Mrs. EREWARIFAGHA MININI HAIDOME PMHNP-BC
14036 170TH ST
JAMAICA, NY 11434-4632
Phone number: 347-843-7760
Mailing Address
Mrs. EREWARIFAGHA MININI HAIDOME PMHNP-BC
3963 MURDOCK AVE
BRONX, NY 10466-2442
Phone number: 347-281-0304