MEDICARE: MRS. JANINE MIGLINO RN, CPNP

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	363LP0200X	Pediatric Nurse Practitioner	381891	NY
2	363LP0200X	Pediatric Nurse Practitioner	F381891-1	NY

General Provider Information

NPI Number	:	1902032113
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JANINE MIGLINO RN, CPNP

Provider Business Mailing Address
First Line	:	20 LAGOON BLVD
Second Line	:
City	:	MASSAPEQUA
State	:	NY
Zip	:	11758-8042
Country	:	US
Telephone Number	:	516-524-6478
Fax Number	:

Provider Business Practice Location Address
First Line	:	850 FULTON ST STE 4
Second Line	:
City	:	FARMINGDALE
State	:	NY
Zip	:	11735-3601
Country	:	US
Telephone Number	:	516-454-8525
Fax Number	:

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

Provider Enumeration Date	:	06/02/2009
Last Update Date	:	04/29/2022

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