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NPI Code Detail

MEDICARE: JOLANTA KUDELKO

MEDICARE:   JOLANTA  KUDELKO
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
1183500000XPharmacist053725NY

General Provider Information

NPI Number : 1154644862
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOLANTA KUDELKO
Provider Business Mailing Address
First Line : 3191 EMMONS AVE
Second Line : APT 4E
City : BROOKLYN
State : NY
Zip : 11235
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3823 NOSTRAND AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11235
Country : US
Telephone Number : 718-743-8933
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/09/2010
Last Update Date : 03/09/2010

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Directions to “ JOLANTA KUDELKO ” Practice Location

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