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NPI Code Detail

MEDICARE: MRS. LORRAINE ELLEN PSZCZOLA RN

MEDICARE: MRS. LORRAINE ELLEN PSZCZOLA 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 Nurse364786NY

General Provider Information

NPI Number : 1154693471
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LORRAINE ELLEN PSZCZOLA RN
Provider Business Mailing Address
First Line : 112 LENHART ST
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10307-1362
Country : US
Telephone Number : 917-327-2152
Fax Number : 718-966-0458
Provider Business Practice Location Address
First Line : 5 DAKOTA DR
Second Line :
City : NEW HYDE PARK
State : NY
Zip : 11042-1107
Country : US
Telephone Number : 917-327-2152
Fax Number : 718-966-0458
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/01/2012
Last Update Date : 02/01/2012

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