Kamala P Byfield

Individual provider Active NPI Intellectual and/or Developmental Disabilities Residential Treatment Facility · Hollis, NY

NPI 1568615342 · NPPES record last updated Oct 24, 2008

Key facts

NPI
1568615342
Entity type
Individual (NPI type 1)
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X
License
005626-1 (NY)
Practice address
10028 199TH St
Hollis, NY 11423-3327
Phone
(718) 736-6856
NPI assigned
Oct 24, 2008
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
005626-1NYMDRegistered Dietitian

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X 005626-1 NY Yes

Addresses

Primary practice location

10028 199TH St
Hollis, NY 11423-3327

Mailing address

10028 199TH St
Hollis, NY 11423-3327
Phone (718) 736-6856

Other providers in Hollis, NY

All providers in Hollis, NY · Intellectual and/or Developmental Disabilities Residential Treatment Facility in New York

Sources for this page

Verify at the official NPI Registry.