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NPI Code Detail

MEDICARE: DR. MAUREEN VANCURA NP

MEDICARE: DR. MAUREEN VANCURA NP
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
1363LF0000XFamily Nurse Practitioner330465NY

Other Identifiers

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

General Provider Information

NPI Number : 1245302546
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MAUREEN VANCURA NP
Provider Business Mailing Address
First Line : 4425 OLD RIDGE RD
Second Line : PO BOX 934
City : WILLIAMSON
State : NY
Zip : 14589-9363
Country : US
Telephone Number : 315-483-3220
Fax Number : 315-589-4893
Provider Business Practice Location Address
First Line : 4425 OLD RIDGE RD
Second Line : THE COMMONS
City : WILLIAMSON
State : NY
Zip : 14589-9363
Country : US
Telephone Number : 315-483-3220
Fax Number : 315-589-4893
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/14/2006
Last Update Date : 04/20/2011

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