MEDICARE: IVROSE BRUTUS GEORGES

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	163WS0200X	School Registered Nurse	572217	NY

General Provider Information

NPI Number	:	1346956216
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IVROSE BRUTUS GEORGES

Provider Business Mailing Address
First Line	:	944 E 83RD ST # 2
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11236-3813
Country	:	US
Telephone Number	:	347-419-7522
Fax Number	:

Provider Business Practice Location Address
First Line	:	944 E 83RD ST # 2
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11236-3813
Country	:	US
Telephone Number	:	347-419-7522
Fax Number	:

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

Provider Enumeration Date	:	01/25/2023
Last Update Date	:	01/25/2023

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Directions to “ IVROSE BRUTUS GEORGES ” Practice Location

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