MEDICARE: MISS MIZIEL REMOLONA 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
1	363LF0000X	Family Nurse Practitioner	339611	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	NONE	OTHER		NONE

General Provider Information

NPI Number	:	1275045312
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS MIZIEL REMOLONA NP

Provider Business Mailing Address
First Line	:	PO BOX 43
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10463-0043
Country	:	US
Telephone Number	:	929-410-4601
Fax Number	:

Provider Business Practice Location Address
First Line	:	3486 FORT INDEPENDENCE ST
Second Line	:	PH
City	:	BRONX
State	:	NY
Zip	:	10463
Country	:	US
Telephone Number	:	646-404-2970
Fax Number	:

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

Provider Enumeration Date	:	10/30/2017
Last Update Date	:	05/26/2020

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