MEDICARE: NICOLE ABDUL-HALIM

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	164W00000X	Licensed Practical Nurse	313687-1	NY

General Provider Information

NPI Number	:	1124361217
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLE ABDUL-HALIM

Provider Business Mailing Address
First Line	:	1459 WHITE PLAINS RD APT 1R
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10462-4171
Country	:	US
Telephone Number	:	646-851-7507
Fax Number	:

Provider Business Practice Location Address
First Line	:	1459 WHITE PLAINS RD APT 1R
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10462-4171
Country	:	US
Telephone Number	:	646-851-7507
Fax Number	:

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

Provider Enumeration Date	:	03/27/2013
Last Update Date	:	03/27/2013

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Directions to “ NICOLE ABDUL-HALIM ” Practice Location

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