MEDICARE: MS. HERMIA MURSLINE THOMAS-EDWARDS LPN

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	251E00000X	Home Health Agency	179589-1	NY

General Provider Information

NPI Number	:	1427370162
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. HERMIA MURSLINE THOMAS-EDWARDS LPN

Provider Business Mailing Address
First Line	:	1786 TROY AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-2030
Country	:	US
Telephone Number	:	347-891-1059
Fax Number	:	347-702-6234

Provider Business Practice Location Address
First Line	:	1786 TROY AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-2030
Country	:	US
Telephone Number	:	347-891-1059
Fax Number	:	347-702-6234

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

Provider Enumeration Date	:	02/22/2010
Last Update Date	:	02/22/2010

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