MEDICARE: JOSEPHINE TRAMUTOLA NURSE MIDWIFE

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	163WX0003X	Inpatient Obstetric Registered Nurse	NYF0004991	NY
2	367A00000X	Advanced Practice Midwife	NYF0004991	NY

General Provider Information

NPI Number	:	1225250483
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPHINE TRAMUTOLA NURSE MIDWIFE

Provider Business Mailing Address
First Line	:	668 CASTLETON AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10301-2044
Country	:	US
Telephone Number	:	718-448-4300
Fax Number	:	718-448-3999

Provider Business Practice Location Address
First Line	:	668 CASTLETON AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10301-2044
Country	:	US
Telephone Number	:	718-448-4300
Fax Number	:	718-448-3999

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

Provider Enumeration Date	:	05/03/2007
Last Update Date	:	05/19/2020

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