Provider Demographics
NPI:1538436787
Name:CLAXTON, HAZELDINE EUDORA (BS)
Entity type:Individual
Prefix:MISS
First Name:HAZELDINE
Middle Name:EUDORA
Last Name:CLAXTON
Suffix:
Gender:F
Credentials:BS
Other - Prefix:MRS
Other - First Name:VERA
Other - Middle Name:ELMOSA
Other - Last Name:MATTHEW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS
Mailing Address - Street 1:135 EINSTEIN LOOP
Mailing Address - Street 2:#46
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10475-4974
Mailing Address - Country:US
Mailing Address - Phone:718-320-3082
Mailing Address - Fax:718-379-4348
Practice Address - Street 1:135 EINSTEIN LOOP
Practice Address - Street 2:#46
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10475-4974
Practice Address - Country:US
Practice Address - Phone:718-320-3082
Practice Address - Fax:718-379-4348
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-16
Last Update Date:2011-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker