MEDICARE: LORINE R GRIER LPN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	164X00000X	Licensed Vocational Nurse	318386-1	NY

General Provider Information

NPI Number	:	1073925582
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORINE R GRIER LPN

Provider Business Mailing Address
First Line	:	3222 CORSA AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10469-2807
Country	:	US
Telephone Number	:	646-239-0237
Fax Number	:

Provider Business Practice Location Address
First Line	:	3222 CORSA AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10469-2807
Country	:	US
Telephone Number	:	646-239-0237
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/02/2014
Last Update Date	:	06/02/2014

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