MEDICARE: NAHOMIE DUQUENE

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	164W00000X	Licensed Practical Nurse	038571	CT
2	164W00000X	Licensed Practical Nurse	318376-1	NY

General Provider Information

NPI Number	:	1316346240
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NAHOMIE DUQUENE

Provider Business Mailing Address
First Line	:	54 W NORTH ST APT 414
Second Line	:
City	:	STAMFORD
State	:	CT
Zip	:	06902-2227
Country	:	US
Telephone Number	:	203-274-6211
Fax Number	:	203-355-1800

Provider Business Practice Location Address
First Line	:	54 W NORTH ST APT 414
Second Line	:
City	:	STAMFORD
State	:	CT
Zip	:	06902-2227
Country	:	US
Telephone Number	:	203-274-6211
Fax Number	:	203-355-1800

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

Provider Enumeration Date	:	08/15/2014
Last Update Date	:	08/15/2014

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Directions to “ NAHOMIE DUQUENE ” Practice Location

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