MEDICARE: MS. RASHIDA U ADIL RN

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	439160	NY

General Provider Information

NPI Number	:	1366708497
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. RASHIDA U ADIL RN

Provider Business Mailing Address
First Line	:	1858 HAIGHT AVE.
Second Line	:	APT. 1A
City	:	BRONX
State	:	NY
Zip	:	10461
Country	:	US
Telephone Number	:	718-328-2105
Fax Number	:	718-328-8561

Provider Business Practice Location Address
First Line	:	1025 MORRISON AVENUE
Second Line	:	JHS 123
City	:	BRONX
State	:	NY
Zip	:	10472
Country	:	US
Telephone Number	:	718-328-2105
Fax Number	:	718-328-8561

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

Provider Enumeration Date	:	04/03/2012
Last Update Date	:	04/03/2012

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