MEDICARE: ISABEL E HOCEVAR 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	470623	NY
2	163WC1400X	College Health Registered Nurse	470623	NY

General Provider Information

NPI Number	:	1003272618
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ISABEL E HOCEVAR RN

Provider Business Mailing Address
First Line	:	22205 56TH AVE
Second Line	:
City	:	BAYSIDE
State	:	NY
Zip	:	11364-1432
Country	:	US
Telephone Number	:	718-631-6375
Fax Number	:	718-631-6330

Provider Business Practice Location Address
First Line	:	22205 56TH AVE
Second Line	:
City	:	BAYSIDE
State	:	NY
Zip	:	11364-1432
Country	:	US
Telephone Number	:	718-631-6375
Fax Number	:	718-631-6330

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

Provider Enumeration Date	:	01/12/2016
Last Update Date	:	01/12/2016

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