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MISS DEMETRIC BOWMAN
NPI 1073477493
Peer Specialist in Broad Channel, NY

Active since December 10, 2025
814 CROSS BAY BLVD, BROAD CHANNEL, NY 11693(718) 717-4759 Get Directions Write a Review

NPPES record last updated: January 9, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jan 9, 2026, Dec 10, 2025 (2 updates tracked since 2025).

About Miss Demetric Bowman NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MISS DEMETRIC BOWMAN (NPI 1073477493) is an individual peer specialist in Broad Channel, New York, licensed in New York (CRPAP9314) and active in the NPI registry since December 2025.

NPPES Registry Identity

NPI1073477493
Entity TypeIndividualFemale
Primary Taxonomy175T00000X
Provider Legal NameMISS DEMETRIC BOWMAN
Location Address814 CROSS BAY BLVDBroad Channel, NY 11693-1126
Mailing Address814 Cross Bay BlvdBroad Channel, NY 11693-1126 · (718) 717-4759
Phone(718) 717-4759
Sole ProprietorYes
Enumeration DateDecember 10, 2025
Last NPPES UpdateJanuary 9, 20262 updates tracked since enumeration
NPPES CertifiedJanuary 9, 2026
✔ NPI 1073477493 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPeer SpecialistOther Service Providers
Taxonomy Code175T00000X
License✔ Licensed in NY · CRPAP9314
Definition

Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

814 CROSS BAY BLVD, Broad Channel, NY 11693
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Frequently Asked Questions

What is Demetric Bowman's NPI number?

The NPI number assigned to this healthcare provider is 1073477493, enumerated as an "individual" on December 10, 2025.

Where is the provider located?

The provider is located at 814 CROSS BAY BLVD BROAD CHANNEL, NY 11693 and the phone number is (718) 717-4759.

What is the provider's specialty?

Peer Specialist with taxonomy code 175T00000X.