MEDICARE: JUDESHA NUREDINI 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	363LA2200X	Adult Health Nurse Practitioner	F310777	NY

General Provider Information

NPI Number	:	1306573910
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUDESHA NUREDINI NP

Provider Business Mailing Address
First Line	:	1935 SHORE PKWY APT 3D
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11214-7112
Country	:	US
Telephone Number	:	718-840-8546
Fax Number	:

Provider Business Practice Location Address
First Line	:	1738 86TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11214-3716
Country	:	US
Telephone Number	:	212-601-2889
Fax Number	:

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

Provider Enumeration Date	:	08/03/2022
Last Update Date	:	08/03/2022

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