MEDICARE: M S NAPOLEON MD PC

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	174400000X	Specialist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1164470019
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	M S NAPOLEON MD PC

Provider Business Mailing Address
First Line	:	1210 DRIVING PARK AVE
Second Line	:
City	:	NEWARK
State	:	NY
Zip	:	14513-1057
Country	:	US
Telephone Number	:	315-331-8921
Fax Number	:	315-331-8231

Provider Business Practice Location Address
First Line	:	1210 DRIVING PARK AVE
Second Line	:
City	:	NEWARK
State	:	NY
Zip	:	14513-1057
Country	:	US
Telephone Number	:	315-331-8921
Fax Number	:	315-331-8231

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MARY SUSAN NAPOLEON
Credential	:	MD
Telephone Number	:	315-331-8921

Provider Enumeration Date	:	05/04/2006
Last Update Date	:	03/29/2011

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