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NPI Code Detail

MEDICARE: MS. NANCY L BOCCHINO CRNP

MEDICARE: MS. NANCY L BOCCHINO CRNP
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
1261QP2300XPrimary Care Clinic/CenterSPOO1895HPA
2363L00000XNurse PractitionerSP001895HPA
3363LG0600XGerontology Nurse PractitionerSP001895HPA

General Provider Information

NPI Number : 1326209495
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. NANCY L BOCCHINO CRNP
Provider Business Mailing Address
First Line : 4508 CHESTNUT ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19139-3608
Country : US
Telephone Number : 267-787-8300
Fax Number : 267-787-8140
Provider Business Practice Location Address
First Line : 4508 CHESTNUT ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19139-3608
Country : US
Telephone Number : 215-746-6894
Fax Number : 214-746-7838
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2008
Last Update Date : 03/07/2023

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