MEDICARE: BARBARA PORCHEDDU 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	270218-1	NY

General Provider Information

NPI Number	:	1760756951
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARBARA PORCHEDDU RN

Provider Business Mailing Address
First Line	:	1780 OCEAN AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230-5401
Country	:	US
Telephone Number	:	718-758-7657
Fax Number	:	718-758-7607

Provider Business Practice Location Address
First Line	:	1780 OCEAN AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230-5401
Country	:	US
Telephone Number	:	718-758-7657
Fax Number	:	718-758-7607

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

Provider Enumeration Date	:	03/06/2012
Last Update Date	:	03/06/2012

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