Provider Demographics
NPI:1679970560
Name:SAINT FORT, JAMES (RN)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:
Last Name:SAINT FORT
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:JAMES
Other - Middle Name:
Other - Last Name:ST.FORT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:9612 AVENUE N
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11236-5306
Mailing Address - Country:US
Mailing Address - Phone:347-893-7983
Mailing Address - Fax:
Practice Address - Street 1:13 CLEVELAND ST
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580-6003
Practice Address - Country:US
Practice Address - Phone:347-893-7983
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-21
Last Update Date:2015-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY684826163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY684826OtherREGISTERED NURSE
NY$$$$$$$$$OtherU.S.