MEDICARE: MISS NADEGE ISIDOR LPN

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	10 322445	NY
2	163W00000X	Registered Nurse	818941	NY

General Provider Information

NPI Number	:	1164898813
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS NADEGE ISIDOR LPN

Provider Business Mailing Address
First Line	:	97 FOREST GLEN CT
Second Line	:
City	:	NANUET
State	:	NY
Zip	:	10954-4407
Country	:	US
Telephone Number	:	908-209-8740
Fax Number	:

Provider Business Practice Location Address
First Line	:	97 FOREST GLEN CT
Second Line	:
City	:	NANUET
State	:	NY
Zip	:	10954-4407
Country	:	US
Telephone Number	:	908-209-8740
Fax Number	:

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

Provider Enumeration Date	:	08/17/2015
Last Update Date	:	12/23/2025

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Directions to “ MISS NADEGE ISIDOR LPN” Practice Location

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