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NPI Code Detail

MEDICARE: MRS. MICHELE TIMOTHY RN

MEDICARE: MRS. MICHELE TIMOTHY 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 Nurse404565NY

General Provider Information

NPI Number : 1992071583
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MICHELE TIMOTHY RN
Provider Business Mailing Address
First Line : 7115 15TH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11228-2105
Country : US
Telephone Number : 718-837-7737
Fax Number :
Provider Business Practice Location Address
First Line : 7115 15TH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11228-2105
Country : US
Telephone Number : 718-837-7737
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2012
Last Update Date : 04/03/2012

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