MEDICARE: MR. FRANK BOADI 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	164W00000X	Licensed Practical Nurse	305904-1	NY

General Provider Information

NPI Number	:	1558659334
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. FRANK BOADI LPN

Provider Business Mailing Address
First Line	:	100 CASALS PL
Second Line	:	#15 K
City	:	BRONX
State	:	NY
Zip	:	10475-3002
Country	:	US
Telephone Number	:	646-250-3880
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 CASALS PL
Second Line	:	#15 K
City	:	BRONX
State	:	NY
Zip	:	10475-3002
Country	:	US
Telephone Number	:	646-250-3880
Fax Number	:

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

Provider Enumeration Date	:	07/14/2011
Last Update Date	:	07/14/2011

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