MEDICARE: HEMWATIE GOBERDHAN NP

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	163WX0800X	Orthopedic Registered Nurse	335484	NY

General Provider Information

NPI Number	:	1528355773
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEMWATIE GOBERDHAN NP

Provider Business Mailing Address
First Line	:	954 OGDEN AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10452-5477
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	954 OGDEN AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10452-5477
Country	:	US
Telephone Number	:	718-813-1394
Fax Number	:

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

Provider Enumeration Date	:	07/07/2011
Last Update Date	:	07/07/2011

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