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NPI Code Detail

MEDICARE: MS. GINA GUILLANO MCMANUS RN

MEDICARE: MS. GINA GUILLANO MCMANUS 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
1163WP0200XPediatric Registered Nurse5859911NY

General Provider Information

NPI Number : 1063738250
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. GINA GUILLANO MCMANUS RN
Provider Business Mailing Address
First Line : 3093 FEARN PL
Second Line :
City : BRONX
State : NY
Zip : 10465-4111
Country : US
Telephone Number : 917-513-1735
Fax Number : 718-829-6613
Provider Business Practice Location Address
First Line : 3093 FEARN PL
Second Line :
City : BRONX
State : NY
Zip : 10465-4111
Country : US
Telephone Number : 917-513-1735
Fax Number : 718-829-6613
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/13/2010
Last Update Date : 04/13/2010

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