MEDICARE: LORENA LOAIZA ARIAS RN

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	163W00000X	Registered Nurse	741738	NY

General Provider Information

NPI Number	:	1104549005
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORENA LOAIZA ARIAS RN

Provider Business Mailing Address
First Line	:	185 PROSPECT AVE
Second Line	:
City	:	WHITE PLAINS
State	:	NY
Zip	:	10607-2040
Country	:	US
Telephone Number	:	914-804-9060
Fax Number	:

Provider Business Practice Location Address
First Line	:	12 WATER ST
Second Line	:
City	:	WHITE PLAINS
State	:	NY
Zip	:	10601-1401
Country	:	US
Telephone Number	:	914-949-3112
Fax Number	:

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

Provider Enumeration Date	:	09/26/2022
Last Update Date	:	09/26/2022

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