Provider Demographics
NPI:1205627312
Name:ALMAZAR, TENNESSEE REY (RN)
Entity type:Individual
Prefix:
First Name:TENNESSEE
Middle Name:REY
Last Name:ALMAZAR
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:TENNESSEE
Other - Middle Name:ALMAZAR
Other - Last Name:CRISOSTOMO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:7104 JUNIPER VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLE VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11379-1839
Mailing Address - Country:US
Mailing Address - Phone:917-847-7502
Mailing Address - Fax:
Practice Address - Street 1:7104 JUNIPER VALLEY RD
Practice Address - Street 2:
Practice Address - City:MIDDLE VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11379-1839
Practice Address - Country:US
Practice Address - Phone:917-847-7502
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-16
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY712066-01163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse