MEDICARE: HOLLI MOLIN

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	163W00000X	Registered Nurse	424305	NY

General Provider Information

NPI Number	:	1437604725
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HOLLI MOLIN

Provider Business Mailing Address
First Line	:	1727 KIMBALL ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-4303
Country	:	US
Telephone Number	:	917-923-2012
Fax Number	:	718-998-1419

Provider Business Practice Location Address
First Line	:	1727 KIMBALL ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-4303
Country	:	US
Telephone Number	:	917-923-2012
Fax Number	:	718-998-1419

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

Provider Enumeration Date	:	08/17/2016
Last Update Date	:	08/17/2016

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Directions to “ HOLLI MOLIN ” Practice Location

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