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NPI Code Detail

MEDICARE: MRS. LAURA MARIE YACINO RN

MEDICARE: MRS. LAURA MARIE YACINO 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
1163W00000XRegistered Nurse469812-1NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1469812-1OTHERNYNYS REGISTERED PROFESSIONAL NURSE LICENSE #

General Provider Information

NPI Number : 1952620262
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LAURA MARIE YACINO RN
Provider Business Mailing Address
First Line : 117 PARKER RD
Second Line :
City : NARROWSBURG
State : NY
Zip : 12764-6200
Country : US
Telephone Number : 718-441-2835
Fax Number : 718-805-6041
Provider Business Practice Location Address
First Line : 13020 89TH RD
Second Line :
City : RICHMOND HILL
State : NY
Zip : 11418-3301
Country : US
Telephone Number : 718-441-2835
Fax Number : 718-805-6041
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/26/2010
Last Update Date : 06/01/2010

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