MEDICARE: ARLENE ANN-MARIE EDWARDS 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	163W00000X	Registered Nurse	556870	NY

General Provider Information

NPI Number	:	1629208285
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARLENE ANN-MARIE EDWARDS RN

Provider Business Mailing Address
First Line	:	14631 231ST ST
Second Line	:	1ST FLOOR
City	:	SPRINGFIELD GARDENS
State	:	NY
Zip	:	11413-4427
Country	:	US
Telephone Number	:	347-548-4157
Fax Number	:	347-548-4157

Provider Business Practice Location Address
First Line	:	14631 231ST ST
Second Line	:	1ST FLOOR
City	:	SPRINGFIELD GARDENS
State	:	NY
Zip	:	11413-4427
Country	:	US
Telephone Number	:	347-548-4157
Fax Number	:	347-548-4157

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

Provider Enumeration Date	:	07/17/2009
Last Update Date	:	07/17/2009

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