MEDICARE: VANELIE AMICY

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	763251	NY
2	164W00000X	Licensed Practical Nurse	330825	NY

General Provider Information

NPI Number	:	1164912382
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VANELIE AMICY

Provider Business Mailing Address
First Line	:	2916 EASTERN BLVD
Second Line	:
City	:	BALDWIN
State	:	NY
Zip	:	11510-4410
Country	:	US
Telephone Number	:	516-988-5205
Fax Number	:

Provider Business Practice Location Address
First Line	:	6424 18TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11204-3729
Country	:	US
Telephone Number	:	212-687-7464
Fax Number	:

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

Provider Enumeration Date	:	05/14/2018
Last Update Date	:	02/13/2026

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Directions to “ VANELIE AMICY ” Practice Location

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