MEDICARE: BELINDA OWUSU

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	670084	NY

General Provider Information

NPI Number	:	1265852495
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BELINDA OWUSU

Provider Business Mailing Address
First Line	:	120 DEKRUIF PLACE
Second Line	:	APT#20C
City	:	BRONX
State	:	NY
Zip	:	10475-2319
Country	:	US
Telephone Number	:	347-602-7113
Fax Number	:

Provider Business Practice Location Address
First Line	:	120 DEKRUIF PLACE
Second Line	:	20C
City	:	BRONX
State	:	NY
Zip	:	10475-2319
Country	:	US
Telephone Number	:	347-602-7113
Fax Number	:

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

Provider Enumeration Date	:	04/28/2014
Last Update Date	:	04/28/2014

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