Individual provider Active NPI

Camille Koroma, RN

  • Emergency Registered Nurse
  • Brooklyn, NY
National Provider Identifier
1861901571
Registry record updated Sep 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Registered NurseTaxonomy code 163WE0003X
License
725931 Issued in NY
Practice address
263 7TH Ave
Brooklyn, NY 11215-7247
Phone
(718) 780-3148
NPI assigned
Sep 26, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Registered Nurse 163WE0003X 725931 NY Primary

Addresses

Primary practice location

263 7TH Ave
Brooklyn, NY 11215-7247

Mailing address

71 Broadway Apt 7C
New York, NY 10006-2605
Phone (443) 852-8675

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
725931NYMDEmergency Registered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1506384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506384000000",
    "number": "1861901571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 BROADWAY APT 7C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100062605",
            "telephone_number": "443-852-8675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "263 7TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112157247",
            "telephone_number": "718-780-3148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOROMA",
        "first_name": "CAMILLE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-26",
        "last_updated": "2017-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "NY",
            "license": "725931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.