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NPI Code Detail

MEDICARE: MRS. STORY ELMORE

MEDICARE: MRS. STORY ELMORE
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
1174400000XSpecialist
2163W00000XRegistered Nurse878829NY

General Provider Information

NPI Number : 1336522317
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. STORY ELMORE
Provider Business Mailing Address
First Line : 8009 CROSS ISLAND PKWY
Second Line :
City : BELLEROSE
State : NY
Zip : 11426-1362
Country : US
Telephone Number : 917-455-1178
Fax Number :
Provider Business Practice Location Address
First Line : 265 BROADHOLLOW RD STE 200
Second Line :
City : MELVILLE
State : NY
Zip : 11747-4833
Country : US
Telephone Number : 917-455-1178
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2015
Last Update Date : 10/24/2023

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