MEDICARE: VALERIE BONGIOVANNI R.N.

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	RN.390992	OH

General Provider Information

NPI Number	:	1225459977
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VALERIE BONGIOVANNI R.N.

Provider Business Mailing Address
First Line	:	5924 MONICA LN
Second Line	:
City	:	GARFIELD HEIGHTS
State	:	OH
Zip	:	44125-5104
Country	:	US
Telephone Number	:	216-870-1705
Fax Number	:

Provider Business Practice Location Address
First Line	:	5924 MONICA LN
Second Line	:
City	:	GARFIELD HEIGHTS
State	:	OH
Zip	:	44125-5104
Country	:	US
Telephone Number	:	216-870-1705
Fax Number	:

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

Provider Enumeration Date	:	12/25/2013
Last Update Date	:	12/25/2013

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