MEDICARE: AYLA BEIZ UY ESTAVILLO 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
1	163W00000X	Registered Nurse	82661201	NY

General Provider Information

NPI Number	:	1174303838
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AYLA BEIZ UY ESTAVILLO RN

Provider Business Mailing Address
First Line	:	8675 MIDLAND PKWY APT 3F
Second Line	:
City	:	JAMAICA
State	:	NY
Zip	:	11432-3035
Country	:	US
Telephone Number	:	917-592-5726
Fax Number	:

Provider Business Practice Location Address
First Line	:	8675 MIDLAND PKWY APT 3F
Second Line	:
City	:	JAMAICA
State	:	NY
Zip	:	11432-3035
Country	:	US
Telephone Number	:	917-592-5726
Fax Number	:

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

Provider Enumeration Date	:	10/02/2023
Last Update Date	:	10/02/2023

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