MEDICARE: CLAIRE LARODE

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	408201	NY

General Provider Information

NPI Number	:	1265980007
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLAIRE LARODE

Provider Business Mailing Address
First Line	:	138 HOLLAND AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10303-1201
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	138 HOLLAND AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10303-1201
Country	:	US
Telephone Number	:	321-369-8049
Fax Number	:

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

Provider Enumeration Date	:	09/21/2016
Last Update Date	:	09/21/2016

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Directions to “ CLAIRE LARODE ” Practice Location

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