Provider Demographics
NPI:1518618503
Name:EMMANUEL, HAZEL FRANCISCO
Entity type:Individual
Prefix:
First Name:HAZEL
Middle Name:FRANCISCO
Last Name:EMMANUEL
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 1:28 HILLSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10703-1902
Mailing Address - Country:US
Mailing Address - Phone:646-280-6447
Mailing Address - Fax:
Practice Address - Street 1:28 HILLSIDE AVE
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10703-1902
Practice Address - Country:US
Practice Address - Phone:646-280-6447
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-12
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY343503164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse