Haidome, Erewarifagha Minini

Haidome, Erewarifagha Minini is an individual health care provider with primary practice located at 14036 170Th St , Jamaica NY 11434-4632. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is her primary health care specialty. Haidome, Erewarifagha Minini can be contacted via phone (347) 843-7760.

Contact Information

Primary practice address
14036 170Th St Jamaica NY 11434-4632
Phone: (347) 843-7760
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 621055-1 New York
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 403564 New York

Profile Details

NPI number 1114301728
LBN Legal business name Haidome, Erewarifagha Minini
Credentials PMHNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 13th, 2015
Last updated Nov 2nd, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114301728 NPPES
New York Other 1114301728 NPI

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