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NPI Code Detail

MEDICARE: WURAOLA ISMAILA

MEDICARE: WURAOLA ISMAILA
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
1163W00000XRegistered Nurse692839NY

General Provider Information

NPI Number : 1285038141
Entity Type Code : Individual
Provider Name (Legal Business Name) : WURAOLA ISMAILA
Provider Business Mailing Address
First Line : 180 PARK HILL AVE
Second Line : APT 4R
City : STATEN ISLAND
State : NY
Zip : 10304-4763
Country : US
Telephone Number : 347-208-4152
Fax Number :
Provider Business Practice Location Address
First Line : 25 FANNING ST
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10314-5307
Country : US
Telephone Number : 718-289-7900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/21/2014
Last Update Date : 10/21/2014

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Directions to “ WURAOLA ISMAILA ” Practice Location

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