Mickens, Samuel R

Mickens, Samuel R is an individual health care provider with primary practice located at 175 Remsen St Fl 10 , Brooklyn NY 11201-4300. He recently has only one registered license in Nursing Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Mickens, Samuel R can be contacted via phone (718) 852-5552.

Contact Information

Primary practice address
175 Remsen St Fl 10 Brooklyn NY 11201-4300
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Addiction (Substance Use Disorder) 163WA0400X 569459-1 New York

Profile Details

NPI number 1942531132
LBN Legal business name Mickens, Samuel R
Credentials Registered Nurse (RN)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 27th, 2010
Last updated Jan 27th, 2010 - about 14 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 1942531132 NPPES
New York Other 569459-1 RN

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